The overall goal of this career award proposal is to enable Dr. Wang to become an independent investigator n the design of interventions to communicate messages about genetic and environmental risk, with a focus on colorectal cancer. The effective communication of genetic and environmental risk factor information has grown increasingly important as advances in genetic technology continue to shed new light on their contributions to colorectal cancer risk. To date, little is known about how best to communicate risk factor information to increase behavioral motivation, thus limiting the application of these new technologies for public health benefit. The impact of communication about cancer risk factors depends, in part, on the prior beliefs and cognitive representations held about the disease feedback being conveyed. In particular, causal attributions - the beliefs people have about the causes of colorectal cancer - are an important, but understudied, determinant of whether and to what extent individuals take behavioral action to reduce the likelihood of developing the disease. A better understanding of causal attributions for colorectal cancer among the general population is essential in order to systematically and comprehensively delineate how people think about the causes of cancer, and identify those attributions that facilitate, or undermine, screening adherence and lifestyle change. Using a combination of survey and experimental research methodologies, two studies are being proposed that build on each other in logical sequence to 1) describe the nature of causal attributions for colorectal cancer and their association with screening and lifestyle behaviors, and 2) begin to experimentally test the impact of genetic and environmentally-focused risk communication messages on patterns of causal attributions and health behaviors among unaffected individuals. The training plan proposed supports this research by providing the necessary advanced mentoring and coursework in communication science, psychometric methods, intervention strategies, and advanced statistics. This will enable the PI to effectively conduct the studies and prepare her for an R01 submission in year 5, building on the findings obtained to create more refined messages for colorectal screening and prevention. This synergistic program of training and research will be essential to understanding how individuals respond to risk communication messages for colorectal cancer, as well as other cancer sites. Perhaps most importantly, the knowledge gained from these studies will be critical to inform the development and evaluation of theory-guided tailored interventions that focus on conveying genetic and/or environmental risk information to the general population in efforts to promote behavior change and, ultimately, public health benefits.
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