In the United States, Blacks are more likely to die from most cancers than any other racial or ethnic group. Breast, prostate, and colorectal cancers are among the most common cancers in this population. These three cancers take the lives of a far higher proportion of Blacks than Whites, Asians, or Hispanics.
Some of these disparities in diagnosis rates can be linked to lack of access to health care and lower cancer screening rates among Blacks compared to other groups.
“Many people in this community may lack health insurance or a regular doctor to refer them for screenings,” said Cheryl Knott, PhD, co-director of the Center for Health Behavior Research at the University of Maryland and American Cancer Society (ACS) grantee. “We also know there’s a lot of medical mistrust out there.”
But Black churchgoers typically trust their religious leaders. The pulpit of Black churches is a proven, effective place for getting the message out about preventive screenings.
In prior ACS-funded work, Knott and her colleagues developed Project HEAL (Health through Early Awareness and Learning). The program trains a few members of each participating church to be community health advisors.
The advisors incorporate spiritual themes and relevant scripture into a 3-part workshop on breast, prostate, and colorectal cancer prevention and screening. Church members voluntarily register for the workshops, which take place at the church outside of regular church services.
“We train regular folks who are in the church, and who don’t necessarily have a health background, to go through a 13-module training and certification process so that they can become the community health advisor in the church.”-Cheryl Knott, PhD
People who participated in HEAL continued to have increased awareness and screening rates for up to 2 years afterwards.
“If people can hear the message from someone they know and trust, they might be willing to say to that person, ‘I want to get this screening, but I don’t have health insurance,’ and that trained community health advisor can connect them with resources,” Knott said.
Funded by the ACS Research Scholar Grant, Knott wants to expand the program’s reach and ensure that its effects are long-lasting.
Her new research will compare different ways of implementing Project HEAL to see which approach results in more screenings over a longer period. For instance, some churches will implement Project HEAL just as it was carried out in Knott’s prior research. That is, members of Knott’s team will train community health advisors, who will then carry out the program.
Other churches will add three or more additional communication strategies intended to better integrate the health messaging into the church’s overall infrastructure– such as having the:
In a few years, Knott will compare program results to see whether the additional strategies led to additional screening.
“There continues to be a great need in the community to hear the message about screening and prevention,” said Knott. “If you want to move that needle, it happens one person at a time.”