Research on tailoring for health-related behaviors and decision-making has increased dramatically since the early 1990's. Results from numerous randomized trials suggest that tailored communications for cancer prevention and control have a greater influence on behavioral and decision making outcomes than one-size-fits-all approaches. Until recently, however, we had little understanding of why tailored communications influenced behavior, or which components of these communications were effective. CECCR1 funding helped us to organize a concerted interdisciplinary effort to open the 'black box' of health communications interventions, which led to identifying a broad array of psychosocial and communications components relevant to health behavior change and decision making. We also identified important individual characteristics that moderate the impact of health communications messages. Results from several of these studies have already been published, and are leading to significant new research funding and a new generation of health communications investigators. Moreover, CECCR1 results are also being adopted i health care, employer, pharmaceutical, and government settings of the U.S. and other parts of the world The overarching aims of CECCR2 are to: (1) Extend our tailoring research beyond the prevention area to the broader cancer care continuum, including early detection, treatment, and long-term survival; (2) Extend our tailoring research to new clinical and post-treatment settings; (3) Deepen our understanding of the key psychosocial and communications components identified in CECCR1, including motivation, ethnic identity, risk perception, and cognitive processing; (4) Explore methods of tailoring to patient preferences for shared decision making; (5) Develop new social and cognitive neuroscience strategies for identifying immediat impact and mechanisms of health communications messages; (6) Develop new interdisciplinary collaborations with scientists and research institutions; (7) Train a new generation of health communications scientists and practitioners; and (8) Disseminate both the scientific and practical results of our research efforts. Woven through CECCR2 research are crosscutting interests related to: tailoring and relevant communications channels; reaching underserved populations through more relevant and easier-to-proces content; physiological mechanisms of communication effect; and methodological issues of design, data collection, and measurement CECCR2 involves four primary research sites and networks, and collaborations with 34 research investigators from 13 institutions. Because of the ambitious scope of our proposed studies, we have obtained over $10 million in matched funding from other sources to help us carry out the proposed research.
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