South Texas Hispanic churchgoers’ awareness and knowledge of cancer risks, preventive behaviors, and screening recommendations: A baseline assessment from the BHT Big ‘C’ Program
Introduction
Cancer is the leading cause of death among U.S. Hispanics. Lack of adequate health insurance coverage and access to care, compounded by cultural and socioeconomic factors, create an urgent need for culturally-tailored cancer prevention programming to reach this population. Additionally, Hispanics have been shown to have higher rates of unhealthy eating, physical inactivity, and obesity, especially in regions of South Texas. With living a healthy lifestyle being one of the most effective strategies to prevent cancer, cancer prevention programming via promotion of healthy living delivered in a community setting (e.g., church) may be an effective means to prevent cancer for this population.
Methods
Building a Healthy Temple: Preventing the Big ‘C’ (BHT Big ‘C’) is a 12-month, faith-based, cancer prevention program designed for churchgoing Hispanic adults. The program was implemented from 2019-2023 in 10 churches located in Rio Grande Valley. BHT Big ‘C’ aims to: build faith-based community’s capacity to provide congregants’ a supportive, health-conducive environment; promote healthy eating, activity, and bodyweight; and increase awareness and utilization of colorectal cancer screening (CRCS) services. CRCS history and awareness of cancer risk, preventive behaviors, and screening recommendations were assessed as part of the program. Preliminary results are reported.
Results
The anonymous, electronic survey was distributed to 1,520 adult attendees from 10 enrolled churches. Five hundred forty-nine participants completed the survey, with a 55.2% response rate. Participants were from Cameron (64.8%) and Hidalgo (35.2%) counties. A majority of participants were Mexican-American and over the age of 45. Participant cancer-related awareness and knowledge varied across risk factors. The majority of participants correctly identified age, personal and family history of cancer, certain genetic traits, excessive sun exposure, obesity, unhealthy diet, and an inactive lifestyle as cancer risk factors. However, over half of participants failed to distinguish increased risk of cancer from: tobacco use; heavy alcohol consumption; uncontrolled type 2 diabetes; use of certain medications/hormones; and medical history of certain diseases, infections, and immune disorders. On the other hand, over 70% of participants correctly identified key health behaviors to lower cancer risk, including healthy eating, active living, weight management, smoking cessation, and sun protection. Similarly, over half of participants were aware of three out of four routine cancer screening recommendations, but only 42.1% of participants identified lung cancer screening recommendations. Of the 549 people who completed the survey, 65.9% (n = 351) were the recommended age (45-75) for CRCS. While 56.7% of these individuals reported having insurance, many reported no or unknown coverage for CRCS services. Additionally, only 39.4% of eligible adults reported having ever been screened for colorectal cancer.
Conclusion
These preliminary results provide compelling insights into South Texas Hispanic churchgoers’ awareness of cancer risk, prevention, and screening recommendations, as well as CRCS history. Unexpectedly, several key cancer risk factors and preventive behaviors were not identified, indicating a need for more cancer-related health promotion. Our findings for CRCS service utilization corroborate the current literature and demonstrate a need for intervention to increase CRCS utilization among this population.