A Smartphone-Based Intervention to Improve Colorectal Cancer Screening in African American Men

Reducing Colorectal Cancer Health Disparities: An mHealth Intervention to Improve Screening Among African American Men

The goal of this clinical trial is to test a new smartphone-based program designed to help African American men get screened for colorectal cancer (CRC). The main question it aims to answer is: ° Are African American men who complete the smartphone-based program more likely to get screened for colorectal cancer than men who do not? Participants will: Complete a baseline survey asking about their colorectal cancer screening history and their thoughts and beliefs about colorectal cancer and the medical system. Be randomized to receive the new smartphone-based program or to receive text messages containing colorectal cancer education materials designed by the Centers for Disease Control (CDC). The new program sends text messages with information about colorectal cancer. Some of these text messages have links to videos that try to help men overcome anything that may stand in the way of getting screened. Complete a follow-up survey 6 months after the baseline survey. This survey will ask the same questions as the baseline survey. A medical records review will be conducted at 6 months to verify whether participants received a colorectal cancer screening test during the study period. Researchers will compare participants who receive the new smartphone-based program to participants who receive the CDC information. The goal is to see whether the smartphone-based program increasing screening more than standard educational materials available on the internet.

Control condition participants will receive information about colorectal cancer and screening developed by the Centers for Disease Control.

Participants receive text messages that contain information about colorectal cancer and screening. Some text messages include links to videos that are intended to reduce barriers to colorectal cancer screening. Other text messages include links to brief web-based assessments. Responses to assessment questions are used to make sure each man receives only the information relevant to his needs. The main educational content is completed in the first 6 weeks. Additional educational and motivation text messages continue for up to 4 more months if a participant reports not having completed colorectal cancer screening.

Participants receive text messages that include links to videos and/or brochures developed by the Centers for Disease Control. This information is designed to educate the public about colorectal cancer and motivate screening. Text messages are sent every 2-3 days for 6 weeks.

Whether or not a participant received a colorectal cancer screening test since beginning the study. The date and type of screening will be verified via electronic medical records. A value of "0" will be recorded if no screening test is found in the electronic health record. A value of "1" will be recorded if a screening test is found in the electronic health record.

Measured using the 12-item perceived severity subscale of Green and colleagues' (2004) CRC Knowledge, Perceptions, and Screening Survey. Items are averaged to form a score ranging from 0 to 4 with higher scores indicating higher perceived severity.

Measured using the 5-item perceived susceptibility subscale of Green and colleagues' (2004) CRC Knowledge, Perceptions, and Screening Survey. Items are averaged to form a score ranging from 0 to 4 with higher scores indicating higher perceived susceptibility.

Measured using Rawl and colleagues' (2001) 5-item perceived benefits to colonoscopy scale. Items are averaged to form a score ranging from 0 to 4 with higher scores indicating higher perceived benefits to colonoscopy.

Measured using Rawl and colleagues' (2001) 5-item perceived benefits to fecal occult blood test scale. Items are averaged to form a score ranging from 0 to 4 with higher scores indicating higher perceived benefits to stool tests.

Measured using the 15-item Powe Fatalism Inventory. Items are averaged to form a score ranging from 0 to 4 with higher scores indicating higher cancer fatalism beliefs.

Measured using the 16-item CRC Knowledge test subsection of Green and colleagues' (2004) CRC Knowledge, Perceptions, and Screening Survey. The true/false items are scored 1 (correct) or 0 (incorrect) and summed to form a score ranging from 0 to 16. Higher scores indicate greater colorectal cancer knowledge.

Inclusion Criteria: African American/Black not compliant with current United States Preventive Services Taskforce colorectal cancer screening recommendations owns a mobile phone capable of text messaging and accessing webpages able to speak/understand English Exclusion Criteria: personal history of colorectal cancer