Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial

Autor: Jennifer Erb-Downward, Tamara A. Michel, Elisa S. Weiss, Alexis J. Gordon, Carolyn E. Schwartz, Bruce D. Rapkin, Eilleen Sabino-Laughlin, David W. Lounsbury, Linda Bulone, Margaret E. Kemeny, Alison Carpenter
Rok vydání: 2017
Předmět:
Male
Community-Based Participatory Research
Health Knowledge
Attitudes
Practice
Health (social science)
Urban Population
medicine.medical_treatment
Health Behavior
Libraries
Ethnic group
Medically Underserved Area
Community-based participatory research
Participatory action research
Vulnerable Populations
Article
03 medical and health sciences
0302 clinical medicine
Neoplasms
Cancer screening
Ethnicity
Odds Ratio
medicine
Humans
Healthcare Disparities
Program Development
Early Detection of Cancer
Applied Psychology
Medical education
030505 public health
business.industry
Information seeking
Public Health
Environmental and Occupational Health
Middle Aged
Public relations
Health equity
030220 oncology & carcinogenesis
Smoking cessation
Library classification
Female
New York City
Smoking Cessation
Guideline Adherence
Public Facilities
0305 other medical science
business
Psychology
Zdroj: American Journal of Community Psychology. 60:145-159
ISSN: 0091-0562
DOI: 10.1002/ajcp.12161
Popis: Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities.
Databáze: OpenAIRE
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