PRE-VIEW An Interactive Video Doctor to Encourage Cancer Screening

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DESCRIPTION (provided by applicant): With funding from the NCI through the R21 mechanism, we have developed PRE-VIEW (The PREventive VIdeo Education in Waiting Rooms Program). This innovative tool is designed to increase rates of recommended cancer screening and discussions about cancer screening. PRE-VIEW is a multimedia intervention that assesses stage of change for each individual type of cancer screening, uses an interactive Video Doctor who gives feasible, efficient messages targeted to individual stage of change and individual barriers for each cancer, and generates individualized Provider Alerts. PRE- VIEW is novel in that it 1) focuses on all recommended cancer screening for a particular individual 2) is tailored to an individual's stage of change and his/her barriers to screening for each particular cancer and 3) has been pilot tested for feasibility. Our first objective is to determine in a randomized controlled trial (RCT), whether patients who use PRE-VIEW before seeing their physician will be more likely than patients who receive usual care to demonstrate increased rates of screening for breast cancer with mammography; cervical cancer with Pap tests; or colorectal cancer with fecal occult blood tests, fecal immunochemical tests, sigmoidoscopy or colonoscopy when indicated and to engage in shared decision-making with primary care physicians about prostate cancer screening with prostate specific antigen testing (PSA) when indicated. Based on the results of the RCT, our second objective is to tailor and modify PRE-VIEW to facilitate continued adoption, implementation, and maintenance at sites participating in the RCT. Our third objective is to develop a Dissemination and Facilitation Toolkit and a plan for broader dissemination of PRE-VIEW to new primary care clinic sites and to measure the success of dissemination with respect to adoption, uptake and continued use. Our final objective, in preparation for a future proposal, is to begin to adapt PRE-VIEW in two ways: 1) to a new language (Spanish) and 2) for use with different user interfaces, such as the Internet, cell phones or tablets, while still facilitating patient-physician discussion.