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Background: African American women are at greater risk for cervical cancer incidence and mortality than White women. Up to 90% of cervical cancers are caused by human papillomavirus (HPVs) infections. The National Institutes of Health (NIH) co-developed HPV self-test kits to increase access to screening, which may be critical for underserved populations. Purpose/Research Design: This mixed methods study used the Theory of Planned Behavior to examine attitudes, barriers, facilitators, and intentions related to receipt of cervical cancer screening and perceptions of HPV self-testing among church-affiliated African American women. Study Sample/Data Collection: Participants (N = 35) aged 25-53 participated in focus groups and completed a survey. Results: Seventy-four percent of participants reported receipt of cervical cancer screening in the past 3 years. Healthcare providers and the church were supportive referents of screening. Past trauma and prioritizing children's healthcare needs were screening barriers. Concerns about HPV self-testing included proper test administration and result accuracy. Conclusions: Strategies to mitigate these concerns (e.g., delivering HPV self-test kits to the health department) are discussed.
Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Criança , Feminino , Humanos , Neoplasias do Colo do Útero/diagnóstico , Negro ou Afro-Americano , Autoteste , Detecção Precoce de Câncer/métodos , Infecções por Papillomavirus/diagnóstico , Área Carente de Assistência Médica , Papillomavirus HumanoRESUMO
Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.
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Negro ou Afro-Americano , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/prevenção & controle , Promoção da Saúde/métodos , Protestantismo , Comportamento de Redução do Risco , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Adulto JovemRESUMO
The updated National HIV/AIDS Strategy recommends widespread HIV education and testing and calls the faith community to assist in these efforts. Yet, limited information exist on church-based HIV testing interventions. This study examined feasibility and assessed HIV testing outcomes of Taking It to the Pews (TIPS), a multilevel HIV education and testing intervention. Four African American churches were matched and randomized to TIPS or a standard-information control arm. Intervention churches delivered the religiously-tailored TIPS Tool Kit, which included educational materials to individuals and ministry groups; pastoral activities (e.g., sermons preached, receipt of HIV testing role-modeled), responsive readings, and church bulletin inserts in church services; and HIV testing during church services and church outreach events. All churches delivered 2-3 tools/month and coordinated 3 HIV testing events. At 12 months, significant increases in receipt of HIV testing (59% vs. 42%, p = 0.008), and particularly church-based testing (54% vs. 15%, p < 0.001), relative to controls were found. TIPS has great potential to increase reach, feasibility, and impact of HIV testing in African American churches.
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Negro ou Afro-Americano , Relações Comunidade-Instituição , Infecções por HIV/diagnóstico , Promoção da Saúde , Programas de Rastreamento/métodos , Religião , Adolescente , Adulto , Atitude Frente a Saúde , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Religiosos , Testes Sorológicos , Estigma Social , Adulto JovemRESUMO
Colorectal cancer (CRC) incidence among low income populations is disproportionate when compared to the general population. Cancer screening studies show religion as a potentially influential factor in individual screening. The present study was an exploratory analysis of religious involvement (RI) among older safety-net clinic patients who participated in 90-day follow up calls during an intervention trial. Results show RI among participants (n = 185) did not significantly predict nor was associated with screening for CRC (OR = 1.36, p = 0.35). The percentage of participants that self-identified as being highly religious differed across racial/ethnic groups (25% of Non-Hispanic Whites, 22% of Hispanics were highly religious when compared to 52% of Non-Hispanic Blacks). These findings raise questions about the use of religious appeals as part of health promotion for CRC screening and religious involvement among low-income patient populations. Varied religious beliefs across groups suggest while there may be room for including religion in CRC screening promotion targeted to some patients from low income groups, this appeal would not be suitable for other low-income patient sub-populations.
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This study sought to identify characteristics, including religiosity, related to having received health screenings among persons who attend African-American churches or receive church-based community outreach services. A sample of 602 was recruited during two phases as part of a larger project. Blood pressure, cholesterol, and blood glucose screenings were the most frequently reported screenings ever and in the last 12 months. Although religiosity was significantly related to several of the health screenings in bivariate analysis, it is not a predictor of health screenings in multivariate analyses. Innovative strategies are needed to promote screenings such as church-based health fairs.
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Negro ou Afro-Americano/estatística & dados numéricos , Promoção da Saúde/métodos , Programas de Rastreamento/estatística & dados numéricos , Religião e Medicina , Características de Residência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Promoção da Saúde/estatística & dados numéricos , Humanos , Kansas , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto JovemRESUMO
INTRODUCTION: The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. METHODS: Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. RESULTS: At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters, brochures/church bulletins). Overall, participants were highly satisfied with the intervention pilot study. CONCLUSIONS: African American churches may be well positioned to increase the reach of HIV prevention interventions to church and community members and could serve an important role in addressing HIV-related stigma in their church communities. Future research is needed on measuring HIV-related stigma beliefs and on testing intensive, scalable, religiously tailored HIV interventions to impact HIV-related stigma in African American churches.
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Discriminação Psicológica/fisiologia , Infecções por HIV/psicologia , Educação em Saúde/métodos , Estigma Social , Adolescente , Adulto , Negro ou Afro-Americano , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Religião , Estados Unidos , Adulto JovemRESUMO
Increasingly, African American churches have been called upon to assist in efforts to address HIV/AIDS in underserved communities. African Americans churches may be well-positioned to provide HIV education, screening, and support services, particularly if they are equipped with church-appropriate, easy-to-deliver HIV tools that can be implemented through the naturalistic church environment. To inform the development of a church-based HIV tool kit, we examined church capacity with African American church leaders (N = 124 participants; n = 58 churches represented by senior pastors). Nearly all participants (96%) wanted to learn more about HIV and how to discuss it with their parishioners. Regarding church capacity, most of their representative churches held three regular services each week, facilitated various inreach and community outreach ministries, and had paid staff and computers. Also, many of their churches facilitated HIV/AIDS education/prevention and adolescent sex education activities. Guided by church capacity findings, an ecological framework, and a CBPR approach, we describe the resulting church-based HIV Tool Kit that "fits" naturalistically within a multilevel church infrastructure, builds upon churches' HIV-related experience, and equips faith leaders to efficiently promote HIV services with the communities they serve.
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Negro ou Afro-Americano , Relações Comunidade-Instituição , Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Protestantismo , Adolescente , Adulto , Idoso , Clero , Feminino , Educação em Saúde , Humanos , Disseminação de Informação/métodos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estados Unidos , Adulto JovemRESUMO
OBJECTIVES: To use the theory of planned behavior to identify predictors of intentions to use cessation aids when quitting smoking. METHODS: African American smokers completed a survey to assess intentions, attitudes, and normative and control beliefs regarding the use of smoking cessation aids. RESULTS: Participants held mildly positive attitudes regarding the use of cessation aids. Beliefs related to the utility of aids, support of referents, and accessibility of a doctor were most strongly associated with intention to use cessation aids. CONCLUSIONS: African American smokers may be amenable to the use of cessation aids, and specific beliefs may be targets for intervention.
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Negro ou Afro-Americano/psicologia , Intenção , Abandono do Hábito de Fumar/métodos , Tabagismo/tratamento farmacológico , Tabagismo/etnologia , Adulto , Coleta de Dados , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/etnologiaRESUMO
Utilizing a community-based participatory research (CBPR) approach is a potentially effective strategy for exploring the development, implementation, and evaluation of HIV interventions in African American churches. This CBPR-guided study describes a church-based HIV awareness and screening intervention (Taking It to the Pews [TIPS]) that fully involved African American church leaders in all phases of the research project. Findings from the implementation and evaluation phases indicated that church leaders delivered TIPS Tool Kit activities on an ongoing basis (about twice a month) over a 9-month period. TIPS church members were highly exposed to TIPS activities (e.g., 91% reported receiving HIV educational brochures, 84% heard a sermon about HIV). Most (87%) believed that the church should talk about HIV, and 77% believed that the church should offer HIV screening. These findings suggest that implementing an HIV intervention in Black church settings is achievable, particularly when a CBPR approach is used.