***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction The Tepeyac Project is a church-based health promotion project that was conducted from 1999 through 2005 to increase breast cancer screening rates among Latinas in Colorado . Previous reports evaluated the project among Medicare and Medicaid enrollees in the state . In this report , we evaluate the program among enrollees in the state 's five major insurance plans . Methods We compared the Tepeyac Project 's two interventions : the Printed Intervention and the Promotora Intervention . In the first , we mailed culturally tailored education packages to 209 Colorado Catholic churches for their use . In the second , promotoras ( peer counselors ) in four Catholic churches delivered breast-health education messages personally . We compared biennial mammogram cl aims from the five insurance plans in the analysis at baseline ( 1998–1999 ) and during follow-up ( 2000–2001 ) for Latinas who had received the interventions . We used generalized estimating equations ( GEE ) analysis to adjust rates for confounders . Results The mammogram rate for Latinas in the Printed Intervention remained the same from baseline to follow-up ( 58 % [ 2979/5130 ] vs 58 % [ 3338/5708 ] ) . In the Promotora Intervention , the rate was 59 % ( 316/536 ) at baseline and 61 % ( 359/590 ) at follow-up . Rates increased modestly over time and varied widely by insurance type . After adjusting for age , income , urban versus rural location , disability , and insurance type , we found that women exposed to the Promotora Intervention had a significantly higher increase in biennial mammograms than did women exposed to the Printed Intervention ( GEE parameter estimate = .24 [ ±.11 ] , P = .03 ) . Conclusion For insured Latinas , personally delivering church-based education through peer counselors appears to be a better breast-health promotion method than mailing printed educational material s to churches Background Cancer is the leading cause of death among Asian Americans . While Asian Americans are the fastest growing minority population in the United States , they are underrepresented in cancer research and report poor adherence to cancer screening guidelines . Purpose This study utilized data from two large r and omized intervention trials to evaluate strategies to recruit first-generation Chinese American immigrants from community setting s and Chinese American physician practice s. Findings will inform effective strategies for promoting Asian American participation in cancer control research . Methods Chinese Americans who were non-adherent to annual mammography screening guidelines ( Study 1 with 664 immigrant women > 40 years of age ) and to colorectal cancer screening guidelines ( Study 2 with 455 immigrants > 50 years of age ) were enrolled from the greater Washington DC , New York City ( NYC ) , and Philadelphia ( PA ) areas . Both studies trained bilingual staff to enroll Chinese-speaking participants with the aid of linguistically appropriate fliers and brochures to obtain consent . Study 1 adopted community approaches and worked with community organizations to enroll participants . Study 2 r and omly selected potential participants through 24 Chinese American primary -care physician offices , and mailed letters from physicians to enroll patients , followed by telephone calls from research staff . The success of recruitment approaches was assessed by yield rates based on number of participants approached , ineligible , and consented . Results Most participants ( 70 % ) of Study 1 were enrolled through in-person community approaches ( e.g. , Chinese schools , stores , health fairs , and personal networks ) . The final yield of specific venues differed widely ( 6 % to 100 % ) due to various proportions of ineligible subjects ( 2%–64 % ) and refusals ( 0%–92 % ) . The Study 2 recruitment approach ( physician letter followed by telephone calls ) had different outcomes in two geographic areas , partially due to differences in demographic characteristics in the DC and NYC/PA areas . The community approaches enrolled more  recent immigrants and uninsured Chinese Americans  than the physician and telephone call approach ( p < .001 ) . Enrollment cost is provided to inform future research studies . Limitations Our recruitment outcomes might not be generalizable to all Chinese Americans or other Asian American population s because they may vary by study protocol s ( e.g. , length of trials ) , target population s ( i.e. , eligibility criteria ) , and available re sources . Conclusions Use of multiple culturally relevant strategies ( e.g. , building trusting relationships through face-to-face enrollment , use of bilingual and bicultural staff , use of a physician letter , and employing linguistically appropriate material s ) was crucial for successfully recruiting a large number of Chinese Americans in community and clinical setting s. Our data demonstrate that substantial effort is required for recruitment ; studies need to budget for this effort to ensure the inclusion of Asian Americans in health research OBJECTIVES To describe both conditions of a two-group r and omized trial , one that promotes physical activity and one that promotes cancer screening , among churchgoing Latinas . The trial involves promotoras ( community health workers ) targeting multiple levels of the Ecological Model . This trial builds on formative and pilot research findings . DESIGN Sixteen churches were r and omly assigned to either the physical activity intervention or cancer screening comparison condition ( approximately 27 women per church ) . In both conditions , promotoras from each church intervened at the individual- ( e.g. , beliefs ) , interpersonal- ( e.g. , social support ) , and environmental- ( e.g. , park features and access to health care ) levels to affect change on target behaviors . MEASUREMENTS The study 's primary outcome is min/wk of moderate-to-vigorous physical activity ( MVPA ) at baseline and 12 and 24 months following implementation of intervention activities . We enrolled 436 Latinas ( aged 18 - 65 years ) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer , attended church at least four times per month , lived near their church , and did not have a health condition that could prevent them from participating in physical activity . Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months . SUMMARY Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities BACKGROUND Despite evidence of a decline in both incidence and prevalence of colorectal cancer nationwide , it remains the second most commonly diagnosed cancer and the third highest cause of mortality among Asian Americans , including Korean Americans . This community-based and theoretically guided study evaluated a culturally appropriate intervention program that included a bilingual cancer educational program among Korean Americans including information on CRC risks , counseling to address psychosocial and access barriers , and patient navigation assistance . METHODS A two-group quasi-experimental design with baseline and post-intervention assessment and a 12-month follow-up on screening was used in the study . Korean Americans ( N=167 ) were enrolled from six Korean churches . The intervention group received culturally appropriate intervention program addressing accessibility and psychosocial barriers , and navigation assistance for screening . The control group received general health education that included cancer-related health issues and screening . RESULTS There was a significant difference ( p<0.05 ) between the post-intervention and control groups in awareness of CRC risk factors . There was also a significant improvement in the pre-post across HBM measures in the intervention group for perceived susceptibility ( p<0.05 ) and benefits and barriers to screening ( p<0.001 ) . At baseline , 13 % of participants in the intervention group and 10 % in control group reported having had a CRC cancer screening test in the previous year . At the 12-month post-intervention follow-up , 77.4 % of participants in the intervention group had obtained screening compared to 10.8 % in the control group . CONCLUSION While health disparities result from numerous factors , a culturally appropriate and church-based intervention can be highly effective in increasing knowledge of and access to , and in reducing barriers to CRC screening among underserved Koreans INTRODUCTION Health communication interventions have been modestly effective for increasing informed decision making for prostate cancer screening among African-American men ; however , knowledge and informed decision making is still question able even with screening . Church-based programs may be more effective if they are spiritually based in nature . OBJECTIVE The aims of the present study were to implement and provide an initial evaluation of a spiritually based prostate cancer screening informed decision making intervention for African-American men who attend church , and determine its efficacy for increasing informed decision making . DESIGN AND METHOD Churches were r and omized to receive either the spiritually based or the non-spiritual intervention . Trained community health advisors , who were African-American male church members , led an educational session and distributed educational print material s. Participants completed baseline and immediate follow-up surveys to assess the intervention impact on study outcomes . RESULTS The spiritually based intervention appeared to be more effective in areas such as knowledge , and men read more of their material s in the spiritually based group than in the non-spiritual group . CONCLUSIONS Further examination of the efficacy of the spiritually based approach to health communication is warranted Background . African American ( AA ) men continue to have a greater than twofold risk of dying from prostate cancer compared to Whites . Methods . This community-based intervention study employed a quasi-experimental , delayed-control ( cross-over ) design with r and omization at the church-level ( N=345 AA men ) . Results . Logistic regression analyses revealed that the level of knowledge ( b=.61 , P<.05 , Exp (B)=1.84 ) , the perception of risk ( b=2.99 , P<.01 , Exp (B)=19.95 ) , and having insurance ( b=3.20 , P<.01 , Exp (B)=24.65 ) significantly increased the odds of participants who needed screening getting screened during study . Discussion . This study demonstrated the need for education , community involvement , and increased access to encourage minority men to obtain needed health screenings 
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The majority of these studies review ed used pre-post , posttest only with control group , or quasi-experience design s. The Health Belief Model was the most commonly used theory in both groups .
Community-based participatory research and empowerment/ecological frameworks were also used frequently in the Latino/Hispanic studies .
Small media and group education were the top two most popular intervention strategies in both groups .
Although one-on-one strategy was used in some Latino studies , neither group used reducing client out-of-pocket costs strategy .
Client reminders could also be used more in both groups as well .
Current review showed church-based cancer education programs  were effective in changing knowledge , but not always screening utilization .
Results show faith-based cancer educational interventions are promising .