Evaluating Strategies to Present Colon Cancer Screening Information

The use of patient narratives in interventions and their availability on the Internet is
becoming ubiquitous and has far outpaced empirical research to assess how and for whom
narratives are effective. To improve future behavioral interventions that incorporate
narratives, researchers need to identify the best role models to promote colon cancer
screening and examine their potentially different mechanisms of influence.

For the proposed web-based, 3-arm English-language pilot intervention with a brief, 1 month
follow-up, the study investigators will randomize 400 average-risk adults age 50-75 who are
non-adherent to colon cancer screening guidelines and have no cancer history to one of three
groups to read: 1) basic information about colon cancer risk and test options, 2) the same
colon cancer and screening information plus a narrative from a colon cancer survivor, or 3)
the same colon cancer and screening information plus a narrative from someone who got
screened for colon cancer. To better assess behavior change, a 6 and 12 month follow up
survey was added.

All participants will read general information about colon cancer and screening guidelines,
test options, and benefits based on Centers for Disease Control and Prevention educational
materials. Narrative participants will then view a role model that is tailored to each
participant by gender, race/ ethnicity, and age group. Along with a photo will be a brief
message to identify role models as colon cancer survivors or screeners. Narrative conditions
will include a single role model and story of first-person experiences of colonoscopy.
Participants will complete survey measures before and after the information and stories are
presented and at one, 6, and 12 month follow-up. Participation in the first part of the study
will take about 30 minutes and about 15 minutes for the follow up survey. Participants can
complete all study requirements through our website: http://HealthStudy.wustl.edu

This study will examine potential mediators or mechanisms that explain the effects of these
narratives on screening-related outcomes based on a proposed conceptual model. The study
investigators will enroll a diverse sample of participants to explore any differences in
narrative effects by audience characteristics (potential moderators).

Inclusion Criteria:

- Male and female adults of any race or ethnicity living in the United States

- Age 50-75 years old

- Access to the Internet to complete all study requirements at
http://HealthStudy.wustl.edu

Exclusion Criteria:

- Unable to read English

- Prior diagnosis of cancer (except non-melanoma skin cancer)

- Prior diagnosis of Crohn's disease, inflammatory bowel disease or colitis

- Currently adherent to colon cancer screening guidelines defined as a home-based stool
blood test in the past 12 months, a sigmoidoscopy in the past 5 years, or a
colonoscopy in the past 10 years.