Internet, web-based communications technology can extend cancer prevention communications to rural populations at a much higher level than ever before. While access to this technology is not universal, its effectiveness should be tested now to provide guidance in designing effective web-based communications for this population. A two-phase project is proposed by investigators from the AMC Cancer Research Center, the University of New Mexico, La Plaza Telecommunity Foundation, and Colorado State University, that will (a) identify the most effective means for promoting adoption of computer/internet technology, (b) author a user-friendly, culturally-appropriate web-based nutrition education program advocating increased consumption of fruits and vegetables to prevent cancer, consistent with NCI's 5 A Day for Better Health Program, and (c) test its effectiveness with the multicultural adult residents of six rural and frontier counties in southern Colorado and northern New Mexico. In Phase I, the web-based program will be authored. Five feasibility studies on critical aspects of computer adoption and multimedia design will be conducted to secure public access computer sites for nonusers, develop selection criteria for lay outreach recruiters, identify successful computer training methods and new user environments, and design user-friendly multimedia interfaces and nutrition education messages. Phase II will contain a randomized, controlled pretest, posttest trial comparing the web-based nutrition education program with a no treatment control condition. Lay outreach recruiters will contact and enroll in the trial adults residents, half of whom are experienced using personal computers and the internet and half of whom have no experience using computers and the internet. Outreach recruiters will conduct the pretest and demonstrate the first module in the web-based nutrition education program. Nonusers will be trained to use computers/internet at public access computer sites throughout the study region by the outreach recruiters and La Plaza staff. Adults will access the web-based program through AMC's web server and La Plaza's local community web server, over six months. They will be posttested by telephone by AMC's Computer-assisted Telephone Interviewing Core. Adults in the control condition will be wait-listed for the intervention, which will be available after they complete the posttest.
