Dissemination of cancer early detection and prevention activities in a community involves the education of both providers and lay persons. A significant bottleneck found in community settings is the practice pattern of the primary care physician. Cancer early detection and prevention is often removed from the routine delivery of medical care in a community-based office practice, often occurring in an idiosyncratic, as requested, manner. Our ability to affect physician practice patterns, and particularly to increase the frequency and quality of early detection and prevention regimens within primary care practices must be based on our ability to convey state-of-science information and resources to the total office practice. Thus, we are proposing the development, implementation, and dissemination of an interactive computer program, entitled CAN-Interact that will allow physicians and their staff to: (a) access and manipulate a cancer early detection and prevention information/ database, (b) enhance their knowledge of cancer prevention and screening techniques, (c) generate preventive care models for individual patients, (d) create a patient database, and (e) provide cancer prevention newsletters that are specifically tailored for each patient. The CAN-Interact software will be integrated into a medical office -system intervention currently being developed through another NCI-funded research project -- North Carolina Prescribe For Health. Through the North Carolina Prescribe For Health study, we will deliver the CAN-Interact program to 34 community-based medical practices with membership in the Old North State Medical Society (the North Carolina affiliate of the National Medical Association, and nation's largest organization of African-American physicians), the North Carolina chapter of the American Academy of Family Physicians, and the North Carolina chapter of the American College of Physicians. The three professional associations provide a unique opportunity to assess and intervene in primary care practices in predominantly rural areas serving minority populations. We anticipate that the national professional associations, the American College of Physicians, the American Academy of Family Physicians, and the National Medical Association, will also help sponsor the CAN-Interact program, and will work to diffuse the program beyond the study period and assist in the dissemination of study results.
