This competing continuation interactive R01 is being submitted by Duke University Medical Center as one of five sites to the National Cancer Institute's Cancer Screening Consortium. The other sites include: Fred Hutchinson Cancer Research Center, RAND-UCLA, State University of New York at Stony Brook, and the University of Massachusetts. This proposal makes a unique contribution to the Consortium by examining how different modes of conveying colorectal cancer (CRC) risk factors affects CRC screening among a high risk occupational group, carpenters. Carpenters are exposed to occupational health hazards (e.g., asbestos, wood dust, solvents) and engage in lifestyle behaviors (e.g., smoking, alcohol use) that may increase their CRC risk. This proposal assesses whether an intervention that highlights and communicates to carpenters these occupational hazards and behavioral risk factors via different modalities (e.g., brochures, telephone counseling) motivates CRC screening. With the aid of the New Jersey Carpenters Trust, the main aims are to assess whether: 1) informing carpenters ages 50 and older about occupational and behavioral risk factors related to CRC, in addition to generic risk factors (e.g., age, family history, polyps), produces incremental increases in CRC screening as compared to providing them with generic risk information only; and 2) the use of targeted telephone counseling, as a motivational adjunct, produces incremental increases in CRC screening as compared to written educational materials. It is expected that carpenters who receive written information about occupational and behavioral risk factors along with telephone counseling that personalizes these risks will have the highest CRC screening rates. This proposal will address the Consortium aims of assessing: 1) the effectiveness of targeted telephone counseling versus a control (e.g., usual care) group; 2) sociodemographic and psychosocial characteristics comparing users versus underusers of CRC screening, and 3) the cost-effectiveness of the intervention. This site will develop the targeted telephone counseling to be used among the other Consortium members. This theoretically driven intervention will target individuals at a stage when risk perceptions are hypothesized to be most influential at initiating behavioral change. The results will: 1) provide much needed information about the efficacy of different modalities of communicating general, behavioral and occupation-related CRC risk factors, and 2) aid in the design of future CRC screening interventions among high risk occupational groups that capitalize on risk communication messages. Such interventions are especially needed among blue-collar workers who are more likely to be exposed to environmental carcinogens and engage in behavioral risk factors that increase CRC risk.
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