An intervention to decrease cancer fatalism among rural elders

Oncol Nurs Forum. 1999 Apr;26(3):583-8.


Purpose/objectives: To evaluate the effectiveness of a video intervention in decreasing cancer fatalism, increasing knowledge of colorectal cancer, and increasing participation in fecal-occult blood testing (FOBT).

Design: Repeated measures, pretest/post-test.

Setting: Senior citizen centers in a rural southern state.

Sample: Individuals were selected and assigned to the study group based on the center they attended. Centers were selected and assigned randomly to an intervention (n = 42) or control (n = 28) group. The age of the participants ranged from 52-92 years (X = 75).

Methods: Pretest measures included the Powe Fatalism inventory, the Colorectal Cancer Knowledge Questionnaire, and the Demographic Data Questionnaire. The intervention group viewed the Medical University of South Carolina's video Telling the Story ... To Live is God's Will, and the control group viewed the American Cancer Society (ACS) video Colorectal Cancer: The Cancer No One Talks About. Hemoccult II kits were distributed to both groups at no cost. Post-test data were collected using the Powe Fatalism Inventory and the Colorectal Cancer Knowledge Questionnaire.

Main research variables: Cancer fatalism, knowledge of colorectal cancer, and participation in FOBT.

Findings: People who viewed the intervention video had a greater decrease in cancer fatalism scores and a greater increase in knowledge of colorectal cancer scores than the control group. Both groups had greater than 60% participation in FOBT.

Conclusions: Telling the Story ... To Live is God's Will is an effective, self-contained, cost-effective intervention to decrease cancer fatalism and increase knowledge of colorectal cancer. The video was as effective as the ACS video on colorectal cancer in increasing participation in FOBT among rural elders. But, because Telling the Story ... To Live is God's Will also decreases cancer fatalism and increases knowledge, the potential exists for the increased screening behaviors to be maintained over time.

Implications for nursing practice: Showing the video in waiting areas of community health centers to facilitate the discussion of colorectal cancer and cancer screening with the healthcare professional is a possibility. Nursing students may benefit from using the video as a model for the integration of beliefs and attitudes in developing culturally appropriate, community-based interventions. More research is needed to determine if the positive outcomes of the intervention (i.e., decreased cancer fatalism, increased knowledge, increased participation in colorectal cancer screening) can be maintained over time.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans / psychology
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Colorectal Neoplasms / prevention & control*
  • Colorectal Neoplasms / psychology
  • Female
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Poverty*
  • Rural Health*
  • United States
  • Videotape Recording