PA BCERF FAQs

Frequently Asked Questions (FAQs) About Coalition and Clinic Participation in
The PA Breast Cancer and Environmental Risk Factor Project

Researchers estimate that 50% of breast cancer risk is related to environmental risk factors which may include pesticides, other chemicals, and diet and lifestyle factors. The PA-BCERF Project is designed to increase the accessibility and personal relevance of current risk factor information to rural women in Pennsylvania. The research component of the PA-BCERF Project will test the following three hypotheses: (1) women will alter their behaviors to reduce their risk of breast cancer if provided with clear and practical information about ways to reduce that risk, (2) those behaviors will more likely occur and be sustained where community health reinforcements or supports are most evident, and (3) women will use their interpersonal networks to share that information with family and friends.[FAQ List]

Our clinic or coalition would like to participate in the PA-BCERF project. If we decide to participate, what will be expected of us?

If your clinic or coalition decides to participate in the PA-BCERF Project, it is likely that your educational programs will not look much different than they currently do, although we have some materials for you to use and two data collection requests.

Distribute a set of the "Science Tips You Can Use" Education Tip Sheets and the recruitment postcard to every participant at your education activity. You can certainly distribute other resources in your programs, just be sure to include the Education Tip Sheets.
Share the minutes from your planning meetings with us on the PA-BCERF Meeting Minutes Form. A meeting attendance list is attached to that form. Return completed PA-BCERF Meeting Minutes Form and Attendance Sheet to the PA-BCERF office at the end of each month.
Complete and return the PA-BCERF Activity Form to the PA-BCERF office after each activity.
Meet with a PABCERF project staff person for about an hour, at your convenience, for a brief follow-up interview.

Reporting expectations have been kept to a minimum. We are very interested in the methods that you use to relay the breast cancer risk reduction information to the members of your county or clinic community, but do not want to burden participants with excessive paperwork.[FAQ List]

As with other programs developed under the Northern Appalachia Leadership Initiative on Cancer (NALIC), clinics and coalitions should assess the need and interest for this program in their communities and develop their plans around those needs. Similar to coalition programs in the past, we assume that 6-8 months of programming will allow sites to reach a large proportion of their population, but we have placed no time requirements on the project.

The time you spend will also depend on whether you focus on a few communities or an entire county. All of your efforts, large or small, will contribute to our learning about what helps people choose to make healthy decisions regarding breast cancer risk reduction.[FAQ List]

It is up to the participating clinic and coalition to assess the specific number you want to reach. Based on past coalition program efforts, it seems feasible that each site could reach the number of people we estimate are needed to produce reliable and hopefully statistically significant estimates of the effect of the program on participants' behavior and attitudes. This number should not influence your programming or your participation. All of your programs, whether they reach one person or a thousand, are an important part of the PA-BCERF project and help us learn about disseminating breast cancer information.[FAQ List]

When someone attends an education program and says that they are willing to participate in the study, what exactly happens?

Each person who attends your programs will receive a packet with the Education Tip Sheets. Attached to those sheets is a postage paid post card that asks if the participant is willing to participate in the PA-BCERF study. When the card is returned, the PA-BCERF staff will send a mail survey to them approximately one month after your activity. The survey will ask them questions about:

their eating and other lifestyle habits
current use of home and garden chemicals
their general health and demographic information
their use of the information gained from the Education Tip Sheets and PA-BCERF educational programming, and
their sharing of information learned from the Education Tip Sheets and educational programming.

The survey is mailed to these individuals two additional times: once about 4 months after the initial survey, and again 12 months after the first survey.[FAQ List]

What will happen with the information that is gained from our activities and program participants?

A number of things will happen with this information. Most importantly, it will be used to design resources and new programs that you and other communities can use to educate people about cancer risk reduction. It will also be used to show other researchers in this field how communities and clinics adapt such information and use it effectively.

Also, after the data is collected and entered into a database, the aggregated results can be shared with interested coalitions and clinics. It can then be used, by you, for future program planning efforts.[FAQ List]

Is it okay if we decide to just focus our programs on diet or pesticides rather than both?

Yes, a coalition or clinic should choose the content of their program appropriate to their communities or target audience. There are many environmental risk factors -- dietary/lifestyle and chemical -- that may influence breast cancer. Since there is so much information involved with these topics, a clinic or coalition may decide to focus on the dietary and other lifestyle factors initially, and then focus on the other environmental risks, or vice versa. They may also decide to focus on individual-level changes and then focus on community-level changes, or vice versa. Ideally, a comprehensive program would address both dietary and chemical use changes at both the individual and community-levels.[FAQ List]

We have decided to only educate about dietary risks (pesticide risks). Will you still ask the participants about pesticide use (dietary habits) on the surveys?

We plan to send the entire survey to all participants since all of the information is found on the Education Tip Sheets. We will know what educational focus your activity (ies) had from your activity forms and will use that information in the research component. [FAQ List]

Yes. The "Science Tips You Can Use" Education Tip Sheets are to be distributed as part of your education efforts. You can supplement the Education Tip Sheets with additional information that you have identified from other reliable sources.[FAQ List]

Yes. The PA-BCERF information is likely to complement your other education efforts and does not need to be separated from your other programs. We hope that the PA-BCERF information becomes a standard part of your current education efforts, including cancer education, nutrition, household management and family life skills.[FAQ List]

What is the difference between the individual and community-level changes referred to in our training and project materials?

An individual-level change is a change in a person’s knowledge, attitude, skill or behavior. A community-level change is a change that occurs outside of the individual, within his or her community, social, educational, family, or work setting. A community-level change can reinforce individual health behaviors. For example, an individual-level behavior change could be choosing to use less pesticides in the home near where children play. A community-level change would be a school district that determines to use less pesticides and adopts integrated pest management practices in school areas. In terms of dietary change, an individual behavior change could be incorporating 5 servings of fresh vegetables into daily family meals. A community-level change would be working to bring economical and local fresh produce into farm markets and grocery stores.[FAQ List]

Your coalition or clinic may decide to focus on individual-level changes, community-level changes, or both. We strongly encourage both individual and community-level changes because individuals practice their healthy habits in their environments. If their environments help them to make healthy choices, they are more likely to keep making them.[FAQ List]

We don’t seem to have enough time or volunteers to do a full community assessment. Is it that important?

A community assessment provides you with information about the actual concerns, issues, or even misinformation that people have regarding environmental risk in your community. It can also help you to locate resources and potential partners for your programs. This information increases your chances of implementing a program that will have an impact on cancer risk reduction.

Certainly any community assessment is limited by the constraints of time and people. Ask yourself what you need to know and how can you get that information effectively and efficiently. The PA-BCERF Community Assessment Tool Kit is composed of numerous tools. You can use one of them or all of them depending on your needs.[FAQ List]

Your assessment should be focused to help you to understand the behaviors of the people you are working with and the specific needs of the community. You may want to collect information about the eating behaviors of your target population: where they eat, how they cook and what they can afford to purchase. You may also want to look at this population’s use of household chemicals and pesticides. What are their perceptions and practices? Are there dangerous behaviors that need to be addressed?

In terms of community-level assessment, you might look at food availability, cultural food practices, and food preferences. Additionally you might consider the kinds of waste generated by your community and its industries and if that waste is processed safely.

There are hundreds of kinds of information that can be gathered in a thorough assessment. To make it manageable, it is best to target your needs and gather information in stages. [FAQ List]

You can obtain community assessment information from a variety of sources. Some of these sources include:

The citizens of your community are your greatest resource (through surveys, interviews, town meetings, focus groups, etc)
PSU Cooperative Extension, EFNEP and WIC
The PA Department of Health
State Health Clinics
County Economic Development office and County Planning Office
Chamber of Commerce
The American Cancer Society
The Cancer Information Service
Environmental Protection Agency

Anytime that you have a question or concern, please do not hesitate to contact the PA-BCERF staff members at Penn State. The phone number is (814) 863-8693. Kathleen Allison coordinates the project and will try to help. If she can’t, she will forward the information to the appropriate staff member. She can also be contacted electronically at kga3@psu.edu.