Cancer Outreach and Education in AfricanAmerican Communities: A PrePost Evaluation Block B MD, UPMCS

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Cancer Outreach and Education in African-American
Communities A Pre-Post EvaluationBlock B MD,
UPMC-Shadyside Primary Care Institute Lin CJ
PhD Heron DE MD, UPMC-Shadyside Hospital,
Department of Radiation Oncology Neal-Ferguson
DL RN, BSN, MPH Bray LA BS, CCRP, NCI Cancer
Information Service Goode T Woods MS.
(University of Pittsburgh Cancer
Institute Centers for Health Hearts and Souls)
Community Partnership Formation 2004 The
Centers for Healthy Hearts and Souls (CHHS), a
community-based health promotion organization,
collaborated with the ROCOG project in Pittsburgh
to conduct and evaluate cancer education sessions
in two African-American neighborhoods.
CANCER 101 40 slides An African-American RN/MPH
presented a culturally-adapted 90 minute version
of Cancer 101 with time for questions.
Cancer 101 was developed by the Spirit of EAGLES
American Indian/Alaska Native Leadership
Initiative on Cancer.
CLINICAL TRIALS 43 slides An African-American
CIS Health Educator used an NCI presentation
about clinical trials during a 90 minute session
with time for questions.

Community Organizing 2004-5
Outreach workers visited over 100 agencies,
stores, community centers, faith-based
organizations, and dwellings in the Hill District
and the Southside of Pittsburgh.
Cancer 101 Curriculum Analysis of Pre-test
Responses Both groups had confidence in early
detection Q11 and treatment Q4. Both groups,
but especially the older group, showed low
understanding of disordered cell growth in cancer
Q1 and inheritance Q9, Q10. The older group
knew better that not all tumors are cancer Q2,
but had poor knowledge about environmental
contributions to cancer risk Q5. Cancer 101
Curriculum Analysis of Post-test Responses same
day Correct answers improved for the younger
Hill group in 13 of 14 categories. The older
Sylvania group showed less improvement. Knowledge
of the relation of smoking and cancer did not
improve. Three answers showed more than 30
improvement heritability, cancer not due to
injury, and the widespread risk of cancer even
without risk factors.
Clinical Trials Curriculum Analysis of Pre-test
Responses Both groups understood the purpose of
clinical trials Q1 and the potential benefit
Q2. Very few people knew the meaning of a Phase
3 trial Q4. The younger Hill group did much
worse than the older Sylvania group on the
questions about the Data Safety Monitoring Board
Q13, obtaining informed consent from research
subjects Q10, and selection for randomized
clinical trials Q6. Clinical Trials
Curriculum Analysis of Post-test Responses same
day Participants improved answers about
protocols, choice of patients for trials, and the
role of tamoxifen. Correct answers improved for
the younger group in 8 of 14 categories. The
older group showed much less improvement.
Members of both groups failed to complete the
last 5 questions due to time limits.
Educational Needs Assessment 2005 CHHS and ROCOG
conducted focus groups employing African American
members of the target communities. The groups
explored knowledge, attitudes and beliefs about
cancer and clinical trials. Curriculum
Development 2006 Three educational modules were
built using a unique partnership of NCI, nursing,
public health, medical and community experts.
Curriculum Evaluation 2006 Cancer 101 and
Clinical Trials pre- and post-tests were done on
the same day as the educational session. The
CKAT was used to evaluate knowledge prior to the
Difficult Situations and Screening discussion and
then again four months later.
DIFFICULT SITUATIONS AND SCREENING 9
scenarios, 5 screening facts A Euro-American
physician and an African-American community
worker administered a newly- developed Cancer
Knowledge Assessment Tool (CKAT). They then
conducted a discussion of of the questions,
debriefing the group about its responses and
clarifying the best answers.
Difficult Situations and Screening Analysis of
Pre-test Responses Both groups dealt with the
difficult scenarios in a thoughtful manner. The
younger Hill group chose better approaches to
dealing with radiation side effects, a
discouraged friend, fear of a breast biopsy, and
lack of health insurance than older Sylvania
residents. However, the younger Hill group showed
much less knowledge about the contribution of
smoking and second hand smoke to cancer risk.
Knowledge about screening intervals was below
desirable levels, especially with colorectal
cancer. The error in that case was on the side
of more frequent screening than recommended.
Participants did somewhat worse on the CKAT as a
function of age.
Discussion Leaders Guide
Difficult Situations and Screening Analysis of
Post-test Responses Four months after the CKAT
discussion, all responses improved compared to
pretest results. Knowledge about dealing with
the dangers of smoking improved appreciably.
Knowledge about early detection of male cancer
increased as well. The interval between routine
colonoscopies was still thought to be more
frequent than recommended. Participants
frequently said Oh, I remember that one! when
re-encountering the scenarios.