Smoking, poor diet and a sedentary lifestyle are among the chief preventable causes of cancer morbidity and mortality in the United States. Prior research has shown that physician counseling, prevention office systems, and computer-tailored health messages can all have an impact on common cancer risk behaviors (smoking, physical inactivity, high dietary fat). A critical question yet to be examined regarding the potential public health impact of computer technology is: If the full impact of computer technology is to be realized to reduce the national burden of cancer, then several challenges remain to be addressed including: Can interactive multimedia be integrated into the larger health care delivery system and then into the development and testing of a computerized set of tools that will be able to deliver theory-and evidence-based tailored messages to improve the dietary, physical activity and smoking patterns of low-income patients in a primary care setting and to improve physician counseling for these behaviors. In the R25 portion of the project, we will bring together investigators with expertise in physician counseling and in creating tailored patient education materials for smoking cessation, physical activity and nutrition, and in applying technology to patient and physician education. The investigators will employ focus groups and in-depth interview methods with all stakeholders involved in the proposed system in addition to pilot tests of the intervention materials and instruments. Information gained from the above formative testing will enable the investigators to create a database of text and graphic messages that will serve as the """"""""paper product"""""""" that will be translated to computer form and evaluated in the R44 portion of this project.
