Project Summary:
Project UPLIFT aims to reduce cancer risk factors for primary and secondary cancers among high-risk Black adults in Milwaukee County by promoting lifestyle behavior change in faith-based communities. Lifestyle behavior change can lower cancer risk through increasing adherence to the American Cancer Society’s guidelines for physical activity (150 minutes/week) and nutrition (follow a healthy eating pattern with a variety of fruits and vegetables, whole grains). Cancer prevention strategies can potentially reduce 40% of cancer cases and nearly 50% of cancer deaths that are due to modifiable risk factors. Key strategies include improving access to nutrition and physical activity resources and lifestyle interventions, particularly among Black adults in Milwaukee who have the lowest rates of fruit/vegetable intake and physical activity among adults in Wisconsin. Just 14.3% of Black adults in Milwaukee meet fruit/vegetable intake and 46.9% meet physical activity recommendations, compared to 15.9% and ~57.0% statewide. Faith-based institutions are abundant in Milwaukee and offering lifestyle interventions through these trusted institutions can greatly improve access to cancer prevention resources among underserved communities. While there is evidence that lifestyle interventions are effective among Black adults, one limitation is adequate reach, defined as the extent to which a program attracts its intended audience. Lifestyle interventions that are faith-based can improve reach among Black adults who attend churches by capturing a population that already meets once or twice per week. Further, faith-based communities housed in churches offer long-term pastoral leaders and support networks that can influence reach of Black adults and behavior change. While churches have been used as a setting for cancer-related health promotion, most interventions focus on primary prevention; however, more work is needed to include adults after a cancer diagnosis (secondary prevention).
Previous studies show that these efforts are influential in impacting lifestyle behavior change and intent to screen for breast, prostate, and colorectal cancers. However, these studies generally focused on primary prevention, with few including secondary cancer prevention. A previous diagnosis of cancer is one of the strongest predictors of a new cancer diagnosis. Therefore, the inclusion of secondary cancer prevention can significantly impact cancer risk reduction by including individuals with a previous cancer diagnosis.
Churches are trusted organizations with long-lasting ties to the community that capture individuals who are less likely to attend a clinic-based intervention for several reasons, including medical mistrust, inconvenient locations, and racial discrimination. In contrast, churches have been shown to be culturally appropriate settings for Black adults who attend church or just want a safe and trusted place in the local community to engage in lifestyle behavior change. This proposal supports the Wisconsin 2020-2030 Cancer Plan goals for risk reduction through lifestyle behavior.