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A. McCall



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    OA 11 - Reducing Burden: Patient-Centered Care (ID 682)

    • Event: WCLC 2017
    • Type: Oral
    • Track: Nursing/Palliative Care/Ethics
    • Presentations: 1
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      OA 11.03 - Reducing Lung Cancer Mortality in Disparate Populations through Cancer-Community Awareness Access Research and Education (C-CARE) (ID 7444)

      11:20 - 11:30  |  Author(s): A. McCall

      • Abstract
      • Presentation
      • Slides

      Background:
      Lung cancer is the leading cause of cancer death in the US. Only 15% are diagnosed at early stage, resulting in a 5-year survival of 17%. Disparities exist among racial/ethnic minorities and the medically underserved and regionally. High mortality is in part due to the prior absence of a lung cancer screening guideline. c-CARE aims to improve cancer health literacy and outcomes in disparate populations. The purpose of c-CARE project is to increase community awareness of lung cancer risk factors and screening criteria, and to connect high-risk individuals to lung cancer screening and tobacco cessation services.

      Method:
      The study approach was Community-engaged Research. Formative development involved vetting the study design with the Community Advisory Board (CAB) to ensure community priorities and concerns were addressed. Curriculum development and intervention evaluation were guided by the Health Belief Model. Community members and Community Health Workers unassociated with the current project were recruited to participate in focus groups and semi-structured interviews to review the curriculum and guide refinement of the survey instruments. Thirteen community sites were enrolled: 9 African- American churches; 3 community clinics that serve the medically underserved, and a community recreation center. Researchers trained four Community Health Workers from within each community site to deliver four education sessions. High-risk individuals were connected to lung cancer screening programs and tobacco cessation. Pre- and post-intervention outcome measures were collected on enrolled participants (n=481) to assess changes in participant knowledge, attitudes and beliefs regarding cancer, perceived barriers and self-efficacy to obtain lung cancer screening and tobacco cessation services.

      Result:
      Participants were majority African American, (n= 481);mean age 58.3 years; 16% were tobacco users. Post intervention knowledge, attitudes and beliefs regarding cancer had significant change (p= 001). Health Belief Model constructs post intervention were significant for Perceived Benefits and Self Efficacy subscales. Spearman correlations were significant between smoking status and Perceived Susceptibility, Perceived Barriers post intervention, Self Efficacy at baseline, Attitude post intervention and Belief at baseline.

      Conclusion:
      Community engaged methods engendered community buy-in of the project, enhanced the study design and development of a culturally acceptable curriculum. The data derived from the focus groups and interviews facilitated the refinement of the curriculum and data collection instruments. Training Community Health Workers to recruit participants and deliver the curriculum facilitates access to a hard-to-reach population, builds community capacity,and ensures curriculum delivery within the social context of the setting.Brief community interventions can increase cancer knowledge and sreening self-efficacy.

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