DESCRIPTION (provided by applicant): Appropriate cancer screening in women 50 and older reduces both colorectal cancer (CRC) and breast cancer (BC) mortality, but adherence to both screening behaviors is inadequate. The purpose of this proposal is to test a tailored and interactive intervention to increase both CRC and BC screening in women 51 to 75 who are non-adherent to CRC but adherent to BC (Group A) or to a group which is non-adherent to both CRC and BC (Group B) screening. The intervention is based on theoretical modeling that will simultaneously address more than one health behavior. We will compare a tailored interactive program delivered via a mailed digital video disc (TIDVD), a cancer screening call (CSC), the combination of a TIDVD + CSC, and usual care to increase CRC and BC screening during a single point of contact. Approximately 2616 women, who are members of a family care practice network and insured by Wellpoint will be assessed for eligibility. Eligible women will be either non-adherent to CRC only (Group A) or non-adherent to both CRC and BC (Group B) screening. After eligibility assessment and consent, women will be enrolled in the study and randomly assigned to the TIDVD, CSC, TIDVD + CSC, or usual care. The TIDVD program and CSC will tailor messages to recipients' perceptions of risk, benefits, barriers, and self-efficacy associated with either CRC or with CRC and BC. Interventions will encourage either CRC screening building on their success with BC screening (Group A) or will encourage both screenings simultaneously (Group B) if the woman is non-adherent to either screening. Women in interventions groups will have the ability to schedule BC or CRC screening via telephone without a clinic visit. All intervention arms can be delivered directly to the women in their homes. One week after baseline telephone assessment, interventions will be delivered. Outcomes will be obtained by telephone interviews as well as through claims data and medical records audit at 6 months. Process data about the intervention will be collected at 4 weeks post intervention. Cost effectiveness will be computed for both interventions to speed translation to practice if either or both are found to be efficacious.
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