Computerized population Programs for Three Cancer Risks

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DESCRIPTION (provided by applicant): The specific aims of this research project are (1) to replicate one of the most effective approaches to behavioral intervention, a series of expert system interventions, for both smoking cessation and reduction of dietary fat on a national sample; (2) to extend the intervention to the reduction of sedentary life style; (3) to develop and assess the effectiveness of an innovative automated counseling intervention, the TLC telecommunications system, applied to the same 3 behavioral risk factors; (4) to compare the effectiveness of the current modular expert system approach with an integrated expert system intervention, and (5) to determine the cost-effectiveness of each of the 3 interventions. All subjects will be at risk for all 3 risk factors and all interventions would intervene on all 3 risk factors simultaneously. The modular expert system intervention involves 3 assessments, each followed by 3 separate feedback reports at 6-month intervals for each of the risk factors. The telecommunications system involves briefer assessments on each risk factor and counseling luring regular telephone contacts over a 12-month period. The integrated expert system intervention involves a single assessment on 3 occasions of all 3 risk factors followed by intervention on all 3 risk factors simultaneously in an attempt to increase efficiency and capitalize on the covariance between the behaviors. All 3 interventions are based on the Transtheoretical Model. The national sample would be 1600 subjects recruited throughout the continental United States using random digit dial telephone methodology. All interventions are designed to impact on a total population and a proactive recruitment procedure will be employed to recruit more than 75 percent of the eligible sample. The design is a 4-group (Control, Modular Expert System intervention, Telecommunications Intervention, Integrated Expert System Intervention) x 3 occasions (0, 12, and 24 months). Each behavioral risk factor will be intervened upon for 12 months and the 3 risk factors will be related simultaneously. The 3 interventions evaluated in this project have the potential to be easily disseminated at low costs to entire populations of at-risk individuals.