Based on classic communications theory and methodology, this project proposes to design, implement, test and evaluate, and refine information and education strategies aimed at DES exposed mothers, sons, and daughters and at their health care providers, including primary care physicians, specialists, nurses and others. The ultimate goal is to reduce DES- related morbidity and mortality in each affected subgroup. Using a quasi-experimental pre-test/post test design, DES awareness, knowledge, attitudes, behaviors and practices will be assessed in phase 1 to provide a data base for phase 2 design and implementation of communications strategies. Two demographically similar regions (one to receive interventions, the other to serve as control) of 100,000-250,000 persons each will be selected consisting of a medium-size city and surrounding, less densely populated and rural areas. Results of best strategies will be evaluated and refined accordingly in phase 3, and prepared as appropriate, for broader dissemination. Each phase will be conducted in close consultation with project consultants, using existing networks, channels of communication and materials to the extent possible. It is anticipated that this project will make a substantial positive contribution to improving DES-related knowledge, attitudes and health practices through the scientific design and evaluation of relevant health communications.
