Physical activity as primary prevention to address cancer disparities

What are successful recruitment and retention strategies for underserved populations? Examining physical activity interventions in primary care and community settings

The purposes of this review are to (1) describe recruitment and retention strategies for physical activity interventions focusing on underserved populations and (2) identify successful strategies which show the most promise for "best practices" recommendations to guide future research. The method used was systematic review. Data on recruitment and retention strategies were abstracted and analyzed according to participant characteristics, types of strategies used, and effectiveness using an ecological framework. Thirty-eight studies were identified. Populations included African American (n = 25), Hispanic (n = 8), or Asian (n = 3) groups. Successful recruitment strategies consisted of partnering with respected community stakeholders and organizations, well-trained study staff ethnically, linguistically, and culturally matched to the population of interest, and use of multiple advertising channels. Successful retention strategies included efficient administrative tracking of participants, persistence, skillful teamwork, and demonstrating a positive, caring attitude towards participants. Promising recruitment and retention strategies correspond to all levels of ecological influence: individual, interpersonal, organizational, and societal.

Racial/ethnic differences in cancer prevention beliefs: applying the health belief model framework

PURPOSE

An understanding of each racial/ethnic group's beliefs about cancer prevention is important for designing/implementing interventions to reduce cancer-health disparities. The Health Belief Model was used to examine racial/ethnic differences in beliefs about cancer and cancer prevention.

DESIGN

The data were from the 2007 Health Information National Trends Survey, a biennial, cross-sectional survey using a random-digit-dial telephone frame and a mailing address frame.

SETTING

A weighted, nationally representative sample of American adults.

SUBJECTS

The sample consisted of 7452 individuals.

MEASURES

Model construct variables (perceived susceptibility; perceived severity; perceived benefits; perceived barriers; cues to action; self-efficacy) and race/ethnicity were assessed.

ANALYSIS

The Rao-Scott χ(2) test and multivariate logistic regression assessed racial/ethnic differences.

RESULTS

The constructs self-efficacy, perceived benefits, and perceived susceptibility were significantly associated with race/ethnicity. The remaining three constructs were not statistically significant. Multivariate analysis revealed Hispanics were less likely to believe they could lower their chances of getting cancer than did African-Americans and whites. Hispanics, Asians, and African-Americans were more likely to believe they had a lower chance of getting cancer in the future than did whites.

CONCLUSION

Culturally relevant health education/promotion interventions need to be developed and tailored to (1) empower Hispanics regarding their ability to prevent cancer and (2) educate racial/ethnic minorities about their susceptibility and risk perception for cancer.

Implementing organizational physical activity and healthy eating strategies on paid time: process evaluation of the UCLA WORKING pilot study

Integrating organizationally targeted wellness strategies into the routine conduct of business has shown promise in engaging captive audiences at highest risk of obesity and obesity-related health consequences. This paper presents a process evaluation of the implementation of the University of California, Los Angeles, Working Out Regularly Keeps Individuals Nurtured and Going (WORKING) pilot study. WORKING focuses on integrating physical activity and nutrition practices into workplace routine during non-discretionary paid work time. The purpose of the evaluation was to assess the quality of implementation and to understand factors that facilitated or hindered organizations' full uptake of the intervention. Fifteen worksites were randomly assigned to an intervention condition. Qualitative data were gathered through routine site visits and informant interviews conducted throughout each worksite's intervention period. Worksites were classified into one of four implementation success categories based on their level of adoption and maintenance of core intervention strategies. Six key factors emerged that were related to implementation success: site layout and social climate, wellness infrastructure, number and influence of Program Champions, leadership involvement, site innovation and creativity. This pilot study has informed the conduct of WORKING II; a cluster randomized controlled trial aimed at enrolling 60-70 worksites in Los Angeles County.

Predictors of retention of African American women in a walking program

OBJECTIVE

To predict retention of African American women 6 months after initiating a community walking program.

METHODS

Demographics, health status, cancer-related health behaviors, and network membership data from baseline wellness questionnaires of 1322 African American women participating in the walking program were analyzed using multivariate logistic regression models.

RESULTS

Seventy-eight percent (n = 1032) of African American women were retained at 6 months. Network membership was the primary predictor of retention.

CONCLUSIONS

Women affiliated with our comprehensive network, which provides ongoing cancer awareness, screening, and prevention programs to reduce cancer health disparities, were more likely to accomplish the first major milestone of the program.