***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: BACKGROUND Low-income African American women are more likely to die of breast cancer than their Caucasian counterparts , and at least part of the difference in mortality results from differential screening adherence . The purpose of this study was to identify more efficacious methods of promoting routine mammography screening in underserved population s. METHODS A prospect i ve r and omized intervention study of 344 low income African American women compared the impact of three interventions on mammography adherence and stage of readiness : ( 1 ) pamphlet only ; ( 2 ) culturally appropriate video ; and ( 3 ) interactive computer-assisted instruction program . RESULTS The interactive computer intervention program produced the greatest level of adherence to mammography ( 40.0 % ) compared to the video group ( 24.6 % ) and the pamphlet group ( 32.1 % ) . When subjects in the pamphlet and video groups were combined to form a non-interactive group , this group had a significantly lower adherence than the group who received the interactive computer intervention ( 27.0 % versus 40.0 % ) . There was also significantly more forward movement in mammography stage of readiness among participants in the computer group ( 52.0 % ) compared to those in the pamphlet group ( 46.4 % ) or the video group ( 31.3 % ) . When combining the non-interactive technology ( pamphlet and video ) there was also more forward movement in mammography stage of readiness for those in the interactive intervention group ( 52.0 % moved 1 or 2 stages ) compared to those in the non-interactive group ( 36.2 % ) . CONCLUSIONS These data indicate that tailored approaches are more effective than targeted messages either in print or video format . Another finding of this study is that interactive interventions are more effective than non-interactive interventions in increasing adherence and moving African American women forward in their mammogram stage of readiness Background African American accrual to prevention trials at rates representative of the disease burden experienced by this population requires additional re sources and focused efforts . Purpose To describe the rationale , context , and criteria for selection of sites that received  Minority Recruitment Enhancement Grants ( MREGs )  to increase African American recruitment to the Selenium and Vitamin E Cancer Prevention Trial ( SELECT ) . To determine if African American accrual was higher among the 15 MREG sites when compared with similar nonawarded sites . Methods Changes in African American accrual at sites that received  MREGs  are compared with changes in a group of 15 , frequency-matched , nonawarded sites  using a quasi-experimental , post hoc analysis .  Successful and unsuccessful recruitment strategies reported by the MREG sites are described . Results The increased number of African American participants accrued per month at MREG sites post- funding was higher than the change at comparison sites by a factor of 3.38 ( p = 0.004 , 95 % CI : 1.51—7.57 ) . An estimated 602 additional African American participants were recruited at MREG sites due to MREG funding , contributing to the overall 14.9 % African American recruitment . Successful recruitment strategies most reported by MREG sites included increasing staff , transportation re sources , recruiting through the media , mailings , and prostate cancer screening clinics during off-hours . Limitations Comparison sites were chosen retrospectively , not by r and omization . Although comparison sites were selected to be similar to MREG sites with regard to potential confounding factors , it is possible that unknown factors could have biased results . Cost-effective analyses were not conducted . Conclusions MREG sites increased African American accrual in the post- funding period more than comparison sites , indicating MREG funding enhanced the sites ’ abilities to accrue African American participants . Targeted grants early in the accrual period may be a useful multi-site intervention to increase African American accrual for a prevention study where adequate African American representation is essential . Clinical Trials 2010 ; 7 : 90—99 . We determined the barriers to and facilitators of  colorectal cancer ( CRC ) screening among two faith-based , inner city neighborhood health centers in Southwestern Pennsylvania . Data from a r and om sample of patients 50 years and older ( n=375 ) were used to estimate logistic regression equations to compare and contrast the predictors of four different CRC screening protocol s : ( 1 ) fecal occult blood test ( FOBT ) ≤ 2 years ago , ( 2 ) colonoscopy ≤ 10 years ago , ( 3 ) lower endoscopy ( colonoscopy or sigmoidoscopy ) ≤ 10 years ago , and ( 4 ) any of these screening measures . Racial differences ( between African Americans or Caucasians ) in type of colon cancer screening were not found . Controlling for covariates , logistic regression equations showed that a physician ’s support of colon cancer screening  was positively associated with the receipt of colonoscopy  ( OR : 19.47 , 95 CI : 5.45–69.54 ) , lower endoscopy ( OR : 10.96 , 95 CI : 3.77–31.88 ) and any colon cancer screening ( OR : 10.12 , 95 CI : 3.36–30.46 ) . Patients who see their physicians more frequently were also more likely to be screened for CRC . Unlike other studies , the faith-based environment in which these patients are treated may explain the lack of racial disparity specific to our measures of CRC screening BACKGROUND In the United States , blacks and Hispanics have lower cancer screening rates than whites have . Studies on the screening behaviors of minorities are increasing , but few focus on the factors that contribute to this discrepancy . This study presents the self-reported willingness by blacks , Puerto Rican Hispanics , and non-Hispanic whites to participate in  cancer screenings  in differing cancer screening situations . METHODS The Cancer Screening Question naire ( CSQ ) , a 60-item question naire , was administered via r and om-digit-dial telephone interviews to adults in three cities : Baltimore , Maryl and ; New York , New York ; and , San Juan , Puerto Rico . RESULTS The 1,148 participants in the CSQ study sample consisted of 355 blacks , 311 Puerto Rican Hispanics , and 482 non-Hispanic whites . Response rates ranged from 45 % to 58 % by city . Multivariable logistic regression analyses revealed that blacks and Puerto Ricans were often more likely ( OR 2.0 - 3.0 ) and never less likely than whites to self-report willingness to participate in cancer screenings regardless of who conducted the cancer screening , what one was asked to do in the cancer screening , or what type of cancer was involved ( with the exception of skin cancer where blacks , compared with whites , had an OR of 0.5 ) . CONCLUSIONS The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs PURPOSE The purpose of this study is to describe the factors associated with the decisions of older African American women to join the PLCO ( Prostate , Lung , Colorectal and Ovarian ) Cancer Screening Trial  when recruited . METHODS African American women between ages 55 and 74 years who were never diagnosed with a PLCO cancer were eligible for our study . Two methods of recruitment were used . First , mailings were sent to a r and om sample of women  describing the PLCO followed by a telephone call to determine interest in the PLCO . If women were not interested in PLCO but consented to participate in our study , they were interviewed immediately . Second , we followed up with African American women who responded to mass mailings sent out  before the start of our study by the Pittsburgh PLCO office  . Women completed an interview about their cancer and clinical trial knowledge , attitudes , beliefs , and behaviors . The responses of women who joined the PLCO Trial are contrasted with the responses of women who did not join . RESULTS Numerous factors were associated with the decision of older African American women to join the PLCO , including perceptions of cancer prevention and detection , the experience of having a loved one with cancer , knowledge of and experience with clinical trials , and beliefs regarding the benefits and risks of clinical trial participation . CONCLUSION Minority recruitment to cancer clinical trials could be increased by design ing interventions focused on individual , organizational , and community needs African American women have a higher  breast cancer mortality rate than whites even when cancer subtype is considered , are more likely to be diagnosed at a later stage , and are less likely to have mammography screening . Structural barriers limit screening but may be less important than clinical care and personal barriers among minority and lower income women . A r and om sample of 178 African American females aged > 40 years from a high cancer risk area was surveyed to associate mammography screening with clinical , structural , and personal barriers . Clinical barriers including patient education and communication were significantly associated with lack of screening in previous 2 years . Personal barriers ( lack of trust and knowledge ) and structural barriers ( lack of insurance , facilities , and providers ) also reduced screening . Results reveal that medical practitioners should be more pro-active in reducing clinical barriers to  mammography screening  among lower income African American women . Improved patient physician communication , education about breast cancer to build knowledge and reduce fears , referral for mammography , and building trust are indicated Background Previous large chemoprevention studies have not recruited significant numbers of minorities . The Selenium and Vitamin E Cancer Prevention Trial ( SELECT ) is a large phase III study evaluating the impact of selenium and vitamin E on the clinical incidence of prostate cancer . Over 400 SELECT study sites in the USA , Canada , and Puerto Rico recruited men to this trial . The SELECT recruitment goal was 24 % minorities , with 20 % black , 3 % Hispanic , and 1 % Asian participants . The goal for black participants was set at 20 % because of their proportion in the United States population and their prevalence of prostate cancer . Methods The minority recruitment strategies in SELECT were to : 1 ) consider minority recruitment during site selection ; 2 ) exp and the eligibility criteria by lowering the age criterion for black men and including men with controlled co-morbid illnesses ; 3 ) develop a national infrastructure ; 4 ) give additional funds to sites with the potential to increase black enrollment ; and 5 ) provide re sources to maximize free media opportunities to promote SELECT . Results SELECT recruitment began in August 2001 and was intended to last five years , but concluded two years ahead of schedule in June 2004 . Of the 35 534 participants enrolled , 21 % were minorities , with 15 % black , 5 % Hispanic , and 1 % Asian . Conclusions Careful planning , recruitment of large numbers of clinical centers and adequate re sources accomplished by the combined efforts of the National Cancer Institute ( NCI ) , Southwest Oncology Group ( SWOG ) , SELECT Recruitment and Adherence Committee ( RAC ) , SELECT Minority and Medically Underserved Subcommittee ( MMUS ) , and the local SELECT sites result ed in attainment of the estimated sample size ahead of schedule and recruitment of the largest percentage of black participants ever r and omized to a cancer prevention trial Participation of African Americans in research trials is low . Underst and ing the perspectives of African American patients toward participation in clinical trials is essential to underst and ing the disparities in participation rates compared with whites . A qualitative study was conducted to discover attitudes of the African American community regarding willingness to participate in breast cancer screening and r and omized clinical trials .  Six focus groups consisting of 8 to 11 African American women ( N = 58 ) , aged 30 to 65 , were recruited from local churches . Focus group sessions involved a 2-hour audio-taped discussion facilitated by 2 moderators . A breast cancer r and omized clinical trial involving an experimental breast cancer treatment was discussed to identify the issues related to willingness to participate in such research studies . Six themes surrounding willingness to participate in r and omized clinical trials were identified : ( 1 ) Significance of the research topic to the individual and /or community ; ( 2 ) level of trust in the system ; ( 3 ) underst and ing of the elements of the trial ; ( 4 ) preference for  " natural treatments "  or  " religious intervention "  over medical care ; ( 5 ) cost-benefit analysis of incentives and barriers ; and ( 6 ) openness to risk versus a preference for proven treatments . The majority ( 80 % ) expressed willingness or open-mindedness to the idea of participating in the hypothetical trial . Lessons learned from this study support the selection of a culturally diverse research staff and can guide the development of research protocol s , recruitment efforts , and clinical procedures that are culturally sensitive and relevant OBJECTIVES To examine patterns and predictors of engagement in a coping and communication support ( CCS ) intervention tailored to the preferences of middle-aged and older patients in the early treatment phase for late-stage cancer . DESIGN R and omized controlled trial examining processes and outcomes of a CCS intervention for patients with late-stage cancer over time . SETTING Two ambulatory cancer clinics providing care for underserved population s in Clevel and . PARTICIPANTS One hundred nine middle-aged ( MA : aged 40 - 60 ) and 101 young-old ( YO : aged 61 - 80 ) patients r and omized to the CCS intervention  , surviving to 3 months after enrollment and averaging 2 months of 24/7 access to the intervention . MEASUREMENTS Engagement was assessed in the average number of patient-CCS practitioner ( CCSP ) contacts per month during the initial 2 months of access to the intervention . Baseline data from patient interviews and chart review s were used to test a model of prediction . RESULTS MA patients averaged more patient-CCSP contacts per month than YO patients ( mean 2.6 + /- 2.5 vs 2.0 + /- 1.2 , P=.02 ) , although both age groups were engaged . African-American patients ( P=.007 ) and those with a higher bl 
    Output:
    
Recommendations from physicians , family members , and friends may promote CCT participation .
Multimedia , and culturally-appropriate recruitment approaches may also be effective in soliciting participation among African Americans .