DESCRIPTION: A "Web-Based Hereditary Cancer Risk Assessment Tool@ was submitted previously (1 R25 CA88094-01) in response to PAR-99-141. The proposal has been significantly revised and is resubmitted in response to PAR-00-137. The investigators have developed and implemented a computer-based touchscreen family history questionnaire which allows provision of a basic cancer risk assessment for the consumer (Westman et al. 2000). Additional study has shown that targeted educational interventions are needed to improve patient care for individuals at highest risk (Sweet et al. 2000). This project seeks to convert the self-contained-kiosk-based questionnaire to a Web-based questionnaire which would be widely available and provide immediate tailored cancer risk assessment. Fear appeal theory is used as the basis for improving the message and response. Hypothesis for R25: A strong cancer risk threat message combined with a strong statement of the benefit of intervention will increase cancer-screening behavior. The first specific aim of the R25 portion of the proposal is to use focus groups to tailor the language of the risk assessment communications. Focus groups will be made up of individuals who completed the touchscreen questionnaire, consented to be contacted for participation in research protocols, and who either subsequently received the highest risk rating along with a recommendation to seek genetic counseling or received an intermediate risk rating with a recommendation to increase surveillance. These individuals will be queried to determine their perceptions of severity of threat, susceptibility to the threat, recommended response, and the degree to which a recommended response will work to avert or minimize the threat. The qualitative data from the focus groups will be used to construct tailored communications which will be most likely to increase cancer-screening behavior. These messages will form the bulk of the paper product for SBIR transfer.
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