Abstract B020: Development of a tailored interactive multimedia intervention (TIMI) to promote colorectal cancer screening among Puerto Ricans
Authors: Velez-Alamo Camille , Fernandez Maria , Acevedo-Fontanez Adriana , Soto-Salgado Marievelisse , Rodriguez-Lebron Jorge L , Llavona-Ortiz Josheili , Serra-Martinez Yolanda , Valencia-Torres Ileska , Colon-Lopez Vivian 
Published: September 2020

Abstract
Colorectal Cancer (CRC) is the second highest incident cancer among men and women in Puerto Rico (PR) however, CRC screening (CRCS) rates remain low. Data from the 2016 Behavioral Risk Factor Surveillance System indicated that only 18.0% of the PR population aged 50 to 75 had undergone a Fecal Occult Blood Test (FOBT) within the past year compared to 8.0% in the United States (US). Additionally, 50.1% of age-eligible Puerto Ricans reported having a colonoscopy in the past 10 years compared to 63.5% in the US. At a national level, the National Colorectal Cancer Round Table established as a goal to reach CRCS rates of 80% by 2018. Improving educational and interventional strategies to promote behavioral changes and screening uptake can help increase CRCS rates in PR. The Community Preventive Services Task Force (the community guide) recommends the adoption of interventions that use small media, based on strong evidence of their effectiveness in increasing colorectal cancer screening by FOBT; yet there is no sufficient evidence for sigmoidoscopy or colonoscopy. Using Intervention Mapping (IM), the Puerto Rico Community Cancer Control Outreach Program of the UPR/MDACC Partnership for Excellence in Cancer Research developed a self-directed tailored interactive multimedia intervention (TIMI) aimed to increase CRCS in Puerto Ricans. To develop a TIMI for the educational program ¡Salud!, Por la Vida, which aims to increase CRCS among non-adherent men and women aged 50 to 75 in FQHCs in PR. We developed a series of tailored CRCS messages that were both culturally and linguistically appropriate. First, the conceptual model and flowchart of the TIMI was developed. The conceptual model included subject matter, length, and user interface. Then, we created the script and storyboard to produce a prototype that was tested within the Community Advisory Group and community members to obtain feedback on cultural relevance and linguistics. The script was adapted according to recommendations and fictional content including acted scenes, testimonials, and animations were produced. The TIMI was Beta tested for sequence, interface, and graphics. During the Beta test, the application was scrutinized for errors or missing elements. The final TIMI is delivered using tablets and consists of brief interactive videos that are tailored by variables considered relevant for CRCS (e.g. perceived risk and family history among others). This innovative and technologic educational intervention, which was developed from a guiding framework, will help increase CRCS among non-adherent to CRCS men and women aged 50 to 75 visiting FQHCs in Puerto Rico. We are currently conducting a randomized behavioral intervention trial in 10 FQHC clinics in PR to test the efficacy of this program on CRCS completion.
Citation Format: Camille Velez-Alamo, Maria Fernandez, Adriana Acevedo-Fontanez, Marievelisse Soto-Salgado, Jorge L Rodriguez-Lebron, Josheili Llavona-Ortiz, Yolanda Serra-Martinez, Ileska Valencia-Torres, Vivian Colon-Lopez. Development of a tailored interactive multimedia intervention (TIMI) to promote colorectal cancer screening among Puerto Ricans [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B020.