THE URBAN CHURCH AND CANCER CONTROL - A SOURCE OF SOCIAL-INFLUENCE INMINORITY COMMUNITIES

A study was conducted to examine the efficacy of a church-based model of social influence in improving access to and participation of unders erved minority women in a cervical cancer control program. The model e xpanded on strategies used in previous hypertension control and health promotion research. A total of 24 churches, stratified by faith tradi tion, were randomly selected to participate in the cancer control prog ram from a pool of 63 churches in a defined geographic area of Los Ang eles County, CA. Female parishioners ages 21 years and older were elig ible to participate in cervical cancer education sessions, and screeni ng was offered to adult women who had not had Papanicolaou tests withi n the last 2 years. Church participation rate was 96 percent. Thirty l ay health leaders were selected by the clergy to serve as messengers, recruiters, and organizers for their respective congregations. Ninety- seven percent of these lay health leaders participated in two training sessions designed to prepare them for their leadership role. Social s upport structures such as child care, meals, or transportation for tar geted women were organized by lay health leaders in 78 percent of the churches. A total of 1,012 women between the ages of 21 and 89 years a ttended educational sessions. Forty-four percent of the eligible women were targeted for screening because they had not had a Papanicolaou t est within the last 2 years or had never been screened. Black women we re 6.6 times more likely than Hispanics to have been screened in the p ast 2 years. Hispanic women were 4.2 times more likely than African Am ericans never to have had a Papanicolaou test or been tested in 3 or m ore years. Overall, 90 percent of the women targeted for screening rec ruitment presented for tests. Fifty-two percent of the churches initia ted cancer control activities by the end of the 2-year period followin g the culmination of the intervention program.The findings suggest tha t a church-based model of social influence can leverage the participat ion of minority women in cervical cancer control, provide access to un derserved Hispanic women in particular, and sustain cancer control act ivities beyond the life of an intervention program. The findings furth er suggest that a more discrete assessment of screening history may im prove the participation levels of African American women, and that the gratis offering of screening services may adversely affect their part icipation rates.