Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial

Bruce D. Rapkin, Elisa Weiss, David Lounsbury, Tamara Michel, Alexis Gordon, Jennifer Erb-Downward, Eilleen Sabino-Laughlin, Alison Carpenter, Carolyn E. Schwartz, Linda Bulone, Margaret Kemeny

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities.

Original languageEnglish (US)
Pages (from-to)145-159
Number of pages15
JournalAmerican Journal of Community Psychology
Volume60
Issue number1-2
DOIs
StatePublished - Sep 2017

Keywords

  • Cancer screening
  • Community-based participatory research
  • Comprehensive dynamic trial
  • Diversity
  • Event-history analysis
  • Interactive systems framework
  • Sustainability

ASJC Scopus subject areas

  • Health(social science)
  • Applied Psychology
  • Public Health, Environmental and Occupational Health

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