Colorectal cancer is the second leading cause of cancer death in the U.S. Unfortunately, the overwhelming majority of U.S. adults over age 50 are not getting screened with FOBTs or sigmoidoscopy, as now recommended by the U.S. Prevention Services Task Force (1996). This project aims to use the infrastructure of the CIS to conduct a four group trail aimed at increasing the proportion of CIS callers over age 50 who obtain FOBTs. The interventions we propose, a brief educational message delivered by CIS telephone information specialist and variations on tailored print communications, are likely to exert a positive impact on colorectal cancer screening behavior. Such interventions have shown promise in other areas and have the potential to be not only effective but also cost-effective. The interventions are theoretically grounded in the Precaution Adoption Model and the Transtheoretical Model. The four group design, with 3812 subjects, will permit us to assess not only the effect of tailored versus untailored messages but also to examine three levels of tailored print communications (TPC), one TPC, multiple TPCs based on baseline data only or multiple TPCs with tailoring based on a second data collection. The design will permit us to answer important questions about how much tailoring is needed and the cost- effectiveness of TPCs. The study outcomes will include not only screening but also measures such as changes in risk perceptions, and shifts in stage or readiness. This project is an integral part of the program project and uses all four cores as key components.
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