This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Colorectal cancer (CRC) is one of the most common, deadly, and preventable forms of cancer with marked divergencein screening, incidence, and mortality rates among African Americans and rural residents as compared to European Americans. The proposed study is a two-phased study designed to gather formative research on which a geographicallytargeted, culturally-appropriate CRC intervention can be developed and/or adapted and pilot tested to address CRC in South Carolina. In Phase 1, the proposed study will consist of a population-based, cross-sectional, telephone survey of men and women (aged 45-75) in SC. The cross-sectional telephone study will permit extensive analyses of CRC knowledge, attitudes, beliefs, experiences, and behavior among a population-based sample of men and women in a state with high rates of CRC. The cross-sectional data will be used to determine key knowledge, attitudes, beliefs, behaviors, experiences, and sociodemographic characteristics related to CRC knowledge;identify preferences for CRC educational information;identify barriers to CRC screening;and allow for the development/adaptation of an evidence-based CRC intervention in Phase 2. The questionnaire will be developed by the investigative team by conducting a systematic literature review, expert review, and pretesting. Questionnaire development will be guided by a conceptual framework drawing from the health belief model, self-efficacy construct, and PEN-3 model. Phase 1 data analysis will allow for the identification of geographic and cultural characteristics on which to base a public health intervention. In Phase2, building upon Phase 1 findings, a geographically-targeted, culturally-appropriate evidence-based CRC intervention will be developed and/or adapted and pilot tested for feasibility. A systematic review of existing evidence-based programs and approaches will be conducted as guided by NCI's Using What Works. The content, format, and target audience of the intervention will be based on Phase 1 findings and additional formative research, including the active participation of a community advisory board, key informant interviews, and expert review. The intervention will be pilot tested with one intervention group and one comparison group. The findings of the proposed study will provide a foundation for future NIH proposals and an R01 intervention trial.
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