No abstract

Church-based interventions have been used to reach racial/ethnic minorities. In order to develop effective programs, we conducted a comprehensive systematic review of faith-based cancer prevention studies (2005~2016) to examine characteristics and promising strategies. Combination terms "church or faith-based or religion," "intervention or program," and "cancer education or lifestyle" were used in searching the five major databases: CINAHL; ERIC; Health Technology Assessments; MEDLINE; and PsycInfo. A total of 20 studies met study criteria. CDC's Community Guide was used to analyze and review group interventions. Analyses were organized by two racial groups: African American (AA) and Latino/Hispanic American groups. Results showed most studies reviewed focused on breast cancer alone or in combination with other cancers. Studies of Latino/Hispanic groups targeted more on uninsured, Medicare, or Medicaid individuals, whereas AA studies generally did not include specific insurance criteria. The sample sizes of the AA studies were generally larger. The majority of these studies reviewed used pre-post, posttest only with control group, or quasi-experience designs. The Health Belief Model was the most commonly used theory in both groups. Community-based participatory research and empowerment/ecological frameworks were also used frequently in the Latino/Hispanic studies. Small media and group education were the top two most popular intervention strategies in both groups. Although one-on-one strategy was used in some Latino studies, neither group used reducing client out-of-pocket costs strategy. Client reminders could also be used more in both groups as well. Current review showed church-based cancer education programs were effective in changing knowledge, but not always screening utilization. Results show faith-based cancer educational interventions are promising. To maximize intervention impact, future studies might consider using stronger study designs, incorporating a variety of proven effective strategies, including those frequently used evidence-based strategies, as well as exploring promising strategies among specific target groups.

Aging in Community (AIC) is the preferred way to age. This systematic review identified promising AIC models in the U.S. and analyzed model characteristics and push-pull factors from older adults’ perspectives. Push factors are those driving older adults to leave, while pull factors attract them to stay in a community. We conducted a two-phase search strategy using eight databases. Phase I identified promising AIC models and Phase II expanded each specific model identified. Fifty-two of 244 screened articles met the criteria and were analyzed. We identified four promising AIC models with the potential to achieve person-environment (P-E) fit, including village, naturally occurring retirement community (NORC), cohousing, and university-based retirement community (UBRC). Each has a unique way of helping older adults with their aging needs. Similar and unique push-pull factors of each AIC model were discussed. Analyses showed that pull factors were mostly program factors while push factors were often individual circumstances. Continued research is needed to address the challenges of recruiting minority older adults and those of lower socio-economic status, meeting older adults’ diverse and dynamic needs, and conducting comparative studies to share lessons learned across the globe.

Objectives This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs. Methods A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan). Results A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p <0.001) and CWST (6.80 vs. 5.38; p <0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p <0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p =0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p =0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor’s recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams. Conclusions Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan’s universal healthcare might play a role on the different healthcare seeking patterns.