use between the groups. The mean number of sessions completed in the intervention group was 5 out of 8. Qualitative data suggested that most patients found the programme and telephone sessions helpful, had made lifestyle modifications to manage their fatigue, felt they were more in control of their fatigue and had greater understanding of this symptom. Modifications were suggested to further improve the programme. Discussion: This pilot study suggests that computerised CBT may be an effective, accessible and acceptable intervention for managing fatigue in MS. The improvements in quality of life and the relatively low cost of the intervention highlight the potential for it to be a costeffective way of offering CBT to this group. Background: Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS). The process of change in cognitive behaviour therapy for chronic fatigue syndrome (CFS) is potentially complex. Methods: First we examined whether cognitive behavioural responses changed after a course of CBT. Second, we investigated which cognitive and behavioural responses were important in mediating change in the treatment of CFS/ME and examined factors which predicted treatment outcome in a specialist clinic in the UK. Findings: Three hundred and fifty six patients entered the study and commenced CBT. Change in catastrophic thinking mediated change in social adjustment in CFS/ME. Extreme behavioural and cognitive avoidance predicted worse social adjustment and fatigue. Discussion: Implications of these findings for understanding treatment process and mechanisms of change in a range of disorders will be discussed. Investigators in these countries are developing behavioral interventions, grounded in the Preventive Health Model (PHM),that can be used to increase CRC screening. In Australia, the Adelaide Colorectal Cancer Collaborative has developed a web-based, interactive decision support tool that utilizes empirical evidence about the predictors of screening to deliver tailored information designed to improve readiness to screen. In several Canadian provinces, the Institute for Health Research Team is carrying out pilot studies of invitation letter promotions related to stool blood testing and colonoscopy, initiating tailored-navigation intervention research, and developing CRC screening management software useful for multiple cancer screening programs. In the United States at the Kimmel Cancer Center of Thomas Jefferson University, preferencebased tailored navigation methods are being tested in diverse populations served by primary care practices. In each setting, developmental research had has been completed and randomized controlled trials of PHM-based interventions are underway. The symposium will elaborate the theoretical foundation for the international research initiatives; describe tailored navigation interventions and provide data on implementation results; and summarize lessons learned to date. Background: Colorectal cancer (CRC) screening is underutilized. Effective methods to increase screening use are needed. This study sought to determine the impact of tailored navigation on CRC screening in primary care. Methods: The study included 154 primary care practice patients who were 50 or more years of age, were eligible for CRC screening, and had an office visit within two years prior to study initiation. Baseline telephone survey data were collected on participant sociodemographic characteristics, psychosocial factors, and screening test (fecal occult blood test (FOBT) or colonoscopy) decision stage. By comparing decision stage data, we identified that test with the highest decision stage (i.e., preferred screening test). Participants who preferred FOBT were sent an FOBT kit and a reminder. Those preferring colonoscopy were sent colonoscopy instructions. After this mailing, a study patient navigator made a telephone call to guide participants towards screening. Six-month endpoint survey and medical records data were obtained. Univariable and multivariable analyses were performed to identify predictors of screening and of change in preferred screening test decision stage. Results: At endpoint, 63 (41%) study participants had screened. From baseline to endpoint, overall screening preference increased for 75 (63%) participants. Age and perceived salience and coherence (i.e., screening is important and sensible) were positive, significant predictors of screening use (p=0.02 and p=0.05, respectively); while only age predicted change in overall screening preference (p=0.03). In 2007, Ontario (population, 12.9 million) launched a provincewide CRC screening program, ColonCancerCheck, offering FOBT to average risk individuals and colonoscopy to individuals with first degree family members affected by CRC. Also in 2007, the Alberta Colorectal Cancer Screening Program was launched, an initiative recommending all provincial residents be tested annually with FOBT (beginning at age 50) while in 2008, the Forzani and MacPhail Colon Cancer Screening Centre, opened in Calgary ( Alberta) the only non-hospital Canadian colon cancer screening facility. In Canada, only 40% report being up-to-date CRC screening using FOBT or endoscopy, with FOBT compliance especially suboptimal. The Canadian Institute for Health Research Team in Population-based Colorectal Cancer Screening was accordingly funded to investigate CRC screening activities in several provinces and to originate multiple activities, notably focus groups aimed at ascertaining optimal methods for promoting FOBT-CRC and Targeted and Tailored-Navigated Intervention Trials that directly test specific approaches to increasing screening uptake. In this presentation, a range of findings will be shared, as related to regionally-diverse Focus Group Studies, pilot studies of invitation letter promotions on a provincial basis (Ontario) and to individuals awaiting colonoscopies (Alberta); and Tailored-Navigation interventions directed at attendees of a large primary care practice where patient navigators undertake promotion/ information related to screening promotion. Findings will also be shared from efforts in Saskatchewan, Canada to develop CRC screening management software. In 2006, the Australian government implemented the National Bowel Cancer Screening Program. Invitations were sent to people turning 55 and 65 years. They offered the opportunity to screen for Bowel Cancer with the Faecal Immunochemical Test. Participation rate was 39.7%. This less than optimal uptake highlights the size of public health challenge. How do we optimize participation rates utilizing publicly delivered rather than clinician-based interventions?