LAWRENCE — African-American men and women are No. 1 and 2, respectively, when it comes to mortality rates from colorectal cancer. Yet in the eyes of many informative programs aimed at reaching these populations are rare. A University of Kansas professor has published initial findings from a program aimed at studying the effectiveness of urban churches in leading efforts to communicate information about colorectal cancer to African-Americans.
Crystal Lumpkins, courtesy assistant professor in the William Allen White School of Journalism and Mass Communications and assistant professor in the Department of Family Medicine, is principal investigator of a five-year, $600,000 National Cancer Institute grant to study the effectiveness of churches as a means to promote cancer awareness. She and her research team have published initial findings and presented them at academic conferences in Baltimore, Kansas City and Atlanta.
Lumpkins’ research found that pastors were willing to include health information as part of their mission, but they indicated that they had not thought about becoming the primary source of colorectal cancer prevention information for their congregation prior to the study. There was also distrust of the medical profession, lack of knowledge about colorectal cancer and barriers to health care reported among the participants.
Lumpkins and colleagues Candice Coffey, family medicine resident; Christine Daley, associate professor, and K. Allen Greiner, associate chair of research for family medicine at KU Medical Center, conducted more than 20 focus groups with more than 130 pastors and congregants of urban churches in Kansas City, Kan., and Kansas City, Mo. In addition, about a dozen interviews were conducted with pastors in the area. The majority of pastors indicated that they do view communicating the serious risks of colon cancer and the importance of screenings as part of their job. Although it is not their primary purpose, such communication is important in ensuring the health of their communities and congregations, Lumpkins said.
The researchers found that, among congregants, there was often a reluctance to take part in cancer screenings for several reasons, including a lack of knowledge about the importance of screening, the inability to afford the tests and, perhaps most troubling, a distrust of the medical profession.
“For this population, specifically African-American men, there is often a distrust of doctors. Many said that they thought they were only in it for the money,” Lumpkins said. “There was also resistance to the screenings as they felt they were invasive or uncomfortable. There are also unfortunate health care barriers, and sometimes people had to decide ‘do I screen, or do I eat?’”
Colorectal cancer is the third most commonly diagnosed cancer in the United States and also the third-leading cause of cancer death. If detected early, it is one of the most curable cancers. However, the mortality rate for colorectal cancer among African-Americans is disproportionately high, and many participants in the study were unaware of the risks and symptoms of the cancer. Both pastors and congregants also indicated that it was a topic that had not been discussed in their churches, even though other cancers such as breast and prostate cancer were. In addition to cancer, about half of pastoral respondents reported that they have health ministries in their churches that cover topics such as exercise, CPR, blood pressure monitoring and HIV/AIDS.
While colorectal cancer was not indicated as a topic they discuss, the majority of those taking part in the study agreed that the church could be an important part of communicating information about risk and prevention.
“When the things that are promoted from the pulpit or the pastor endorses, people for whatever reason pay more attention to those things than they do otherwise. And the fact that it’s driven by the pastor and other influential leaders in the church will be, I think will bring the significant amount of attention to it, whereby people will then follow those instructions,” one respondent said.
The study is a community-based participatory research program that aims to bring faith-based organizations and researchers together to address cancer and other health disparities in the future. With the initial data in hand, Lumpkins and colleagues are beginning to work with the churches to create communications materials the congregations can use to promote awareness of colorectal cancer and prevention. Researchers are gathering opinions on what methods of communication and messages are most trusted and effective for the communities. Some of the materials are tailored or pastor-endorsed brochures or messages that will be disseminated via social media. Participants stated the pastor-endorsed communication materials could possibly increase and encourage screenings and shared information within the population.
The goal is to not only find out what attitudes and beliefs exist about colorectal cancer among church members and pastors, but to create sustainable health promotion and health communication programs that can positively affect screening behavior through persuasive communication about colon cancer. The information would then be used to communicate with their congregations, a community that has traditionally been underserved about the importance of cancer prevention. In addition to the research conducted, the group has offered other free health screenings and held health conferences for pastors. They hope to eventually develop health promotions and health communication programs that could be used in urban churches beyond the region.
“We’re not looking at these communities as one-dimensional, but holistically,” Lumpkins said. “We’re looking at more than colon cancer as well. We want to look at questions such as health care access. It’s not just about the research, it’s about building relationships.”