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Preventing Cancer through Environmental Changes


Host Institution
Emory University (previous center): Prevention Research Center

Health Topics

Environmental changes can reduce the risk for cancer, and the researchers explored environmental changes appropriate for residents in rural southwest Georgia. Researchers partnered with the Southwest Georgia Cancer Coalition and a Community Advisory Board (a collaboration of individuals and organizations across 31 counties) on the following 3 projects: (1) a qualitative study; (2) a community survey; and (3) a pilot test of Healthy Homes/Healthy Families, a program that promotes good nutrition and physical activity (PA) by training community members to coach residents on how to make their homes healthier.

In a qualitative study, the study team conducted in-depth interviews of 60 residents of Terrell or Calhoun counties who were older than 50 years and who had lived in those counties for more than 10 years. The responses provided an understanding of how respondents’ families, faith-based organizations, and work sites influence health risk behaviors (such as smoking, unhealthy diet, and physical inactivity) associated with several types of cancer. For example, the interview results suggested that church-based nutrition and exercise programs were rare, but that social support from church members for healthy eating and PA was fairly common.2 The interviewees reported that the major barrier to PA was lack of recreational facilities.3The findings provided the foundation for surveys of a greater number of residents in rural southwest Georgia.

From 2006–2007, researchers conducted a survey of 268 residents of Sumter, Worth, Decatur, and Brooks counties to assess their health and risk factors—such as whether they smoke; how much fat, fruits, and vegetables they consume; their self-reported height and weight; their PA level; and the social factors (such as social support for PA) and environmental factors (such as availability of PA equipment) at home, church, and work sites that may promote or undermine healthy habits. A key finding was that participants who lived in homes having both high social support (household members often encourage PA) and some exercise equipment (an average of 2.7 pieces) reported higher levels of vigorous, moderate, and total PA than did participants who reported low PA; differences were statistically significant.1 On the basis of this finding and the high prevalence of overweight and obesity, the center’s community advisory board chose to focus on increasing healthy eating and PA at home by implementing the home-based program described next. Six months and 12 months later, researchers reassessed about half of the respondents found to have been at increased risk for cancer—on the basis of the initial assessment—to see if their behaviors and environments (access to PA equipment and programs) had changed. Final analyses of the follow-up data are in progress.

For the third project, the team developed and conducted a feasibility test of Healthy Homes/Healthy Families, an in-home program designed to coach families about improving their eating and PA habits by changing their home environments. Three community members were trained as coaches to promote healthy at-home eating, by recommending healthy food purchases and preparation methods. Coaches provided 60 households in Randolph and Cook counties with 2 home visits and 2 telephone calls over 6 weeks. The coaches and families created a profile of the home environment that documented food found in the home, food preparation methods, and PA equipment. Using the profile, the coaches and families developed a family contract and set goals to improve the home environment. Participants completed surveys at the start of the program and 2- and 4-months later, reporting on foods in their homes, eating habits, food purchases, and PA levels. In the 2-month survey, families in the intervention group reported having increased the types and quantity of healthy foods and decreased unhealthy foods and beverages in the home, using healthier food preparation methods, having fewer meals and snacks while watching television, and more frequently purchasing healthy foods than did comparison families in Mitchell County, which did not receive the program. Preliminary results suggest that coaching, combined with a focus on the home environment, may be a promising strategy for improving families’ nutrition.4 Researchers are finalizing data analysis and continue to test the program to determine its effectiveness.

1. Kegler MC, Swan DW, Alcantara I, Wrensford L, Glanz K. Environmental influences on physical activity in rural adults: the relative contributions of home, church and work settings. J Phys Act Health. 2011 Oct 4. [Epub ahead of print]

2. Kegler MC, Escoffery C, Alcantara IC, Hinman J, Addison A, Glanz K. Perceptions of social and environmental support for healthy eating and physical activity in rural southern churches. J Relig Health. 2010 Sep 14. [Epub ahead of print]

3. Kegler MC, Escoffery C, Alcantara I, Ballard D, Glanz K. A qualitative examination of home and neighborhood environments for obesity prevention in rural adults. Int J Behav Nutr Phys Act. 2008;5:65. Available at

4. Kegler M, Alcantara I, Veluswamy JK, Swan D, Hotz JA, Glanz K. Results from a pilot intervention to improve home nutrition environments in rural families. Presentation abstract #225603 for the 138th American Public Health Association Annual Meeting, Nov 6–10, 2010.
Research Setting
Community | Rural area
Race or Ethnicity
Black or African American | White
No specific focus
Age Group
No specific focus
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Principal Investigator
Karen Glanz, PhD

Project Identifier
Preventing Cancer through Environmental Changes - Core Project (2004-2009)

Funding Source
PRC Program

Project Status
Not active