The proposed research is a continuation and refinement of the Cancer Control Science Program Project at the Fox Chase Cancer Center. The Program Project is built upon the foundation of three strong cores: Leadership, EpiStat and Behavioral Research. The proposal includes five interrelated projects to evaluate cost- effective, replicable strategies for fostering adherence to primary and secondary cancer prevention regimens among high-risk populations. In addition to utilizing a team of experienced cancer control investigators, there are several elements that contribute to the strength and unity of this proposal. They include: (1) a common planning model and theoretical approach to the problem of cancer control adherence; (2) the application of similar interventions such as self-help, mailed and telephone reinforcements and group interventions; (3) the use of core instruments and similar classes of variables so that the projects in total will be greater than the sum of the parts; (4) a similar set of educational principles including relevance, individualization, feedback reinforcement and facilitation; (5) focus on high risk, underserved populations in a variety of settings and (6) three levels of evaluation and similar methods of data collection. The projects are follows: Project 1--Clear Horizons: Adherence to a Smoking Cessation Program for Adults 50-74 Years of Age Project 2--Check-Up on Health: Adherence to Cancer Detection Recommended for Older Adults Project 3--Mobile Mammography: Enhancing Adherence at the Worksite Project 4--Bladder Cancer Screening: Enhancing Adherence to a Self-Test Regimen Project 5--Colo-Record Study: Increasing Adherence to Colon Cancer Screening This Phase III and Phase IV cancer control research contributes to the Year 2000 objectives by testing interventions that will enhance adherence to proven cancer control regimens. The interventions are potentially cost-effective, can be applied in a variety of settings and are appropriate for a number of high risk populations.
