African Americans are disproportionately affected by cancer when compared to other racial or ethnic groups. There are a number of social and cultural factors that relate to prevention and screening behaviors that impact cancer mortality rates. Religious/spiritual involvement appears to be one of these factors. We have two ongoing studies that are testing a theoretical model of religious/spiritual involvement and cancer risk, prevention, and screening behaviors, as well as physical and emotional functioning. A set of ten potential mediators are being examined among a national probability sample of African Americans. These are the first known studies to empirically test such models. During the interviews participants were asked if they would be willing to be re-contacted for a subsequent interview. Over 90 percent of participants have indicated yes. We now have a unique and time-sensitive opportunity to conduct a four-year follow-up of these two research cohorts, providing a longitudinal analysis of the relationships being examined in the parent studies. In addition, we propose to conduct a third wave of longitudinal data collection at six years post baseline. These additional waves of data collection will strengthen the meditational analyses in both of the parent studies. This would provide a much-needed longitudinal test of the religion-health connection, and to our knowledge the only longitudinal analysis of mediators of the religion-health connection. Finally, the proposed study would strengthen cause-effect interpretations, something that cannot be done with cross sectional data. The specific aims of the proposed study are to: (1) Expand two of our ongoing cross-sectional investigations into longitudinal cohort studies, by conducting a four-year and a six-year follow-up assessment among our cohort of 3,173 healthy African American adults;and (2) Develop and disseminate recommendations for practice, based on findings from Specific Aim #1. For example, we will identify mediators and outcomes that appear to be modifiable over time, and make recommendations on how to integrate important mediators through which religious/spiritual involvement impacts behavior, into existing cancer screening and prevention programs for African Americans. This could significantly improve effectiveness of programs delivered in faith-based settings, which could have an impact on cancer disparities. PUBLIC HEALTH RELEVANCE: The proposed study will provide a longitudinal analysis of the role of religiosity/spirituality in health behaviors and outcomes in a national sample of African Americans. Study findings will be disseminated, and will directly inform community-based intervention work aimed at the reduction of cancer health disparities in this population, which suffers a disproportionate burden of cancer.