Abstract C11: Development of a tailored interactive multimedia intervention (TIMI) to promote colorectal cancer screening among Puerto Ricans
Authors: Velez-Alamo Camille , Acevedo-Fontanez Adrianna I. , Colon-Lopez Vivian , Soto-Salgado Marievelisse , Serra-Martinez Yolanda , Valencia-Torres Ileska M. , Fernandez Maria E. 
Published: February 2019

Abstract
Introduction: 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 2014 Behavioral Risk Factor Surveillance System indicate that only 18.5% of the PR population 50+ years has undergone an FOBT within the past two years compared to 12.8% in the United States of America (USA). Additionally, only 50.6% of age-eligible Puerto Ricans report ever having a sigmoidoscopy or colonoscopy compared to 68.8% in the USA. At a national level, the goal established by the National Colorectal Cancer Round Table is to reach a CRCS rate of 80% for 2018. Improving educational and interventional strategies to promote behavioral changes and screening uptake can help increase CRCS rates in the island. 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 fecal occult blood test (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.
Objective: Develop a TIMI entitled ¡Salud! por la Vida, aimed to increase CRCS among non-adherent men and women 50 years and older in FQHCs in Puerto Rico.
Methods: We developed a series of tailored colorectal cancer screening messages that were both culturally and linguistically appropriate. First, the concept and flow of the TIMI was developed. The concept includes subject matter, length, and user interface. Then, the script and storyboard were created to produce a prototype that was tested within the Community Advisory Group (CAG) and community members to obtain feedback on cultural relevance and linguistics. The script was adapted according to recommendations and fictional content, including acted scenes and testimonies, 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 consists of brief interactive videos that are tailored by variables considered relevant for CRCS (e.g., perceived risk, family history, among others) and will be delivered using tablets.
Results and Conclusions: This innovative educational intervention using technology and developed from a guiding framework will help increase CRCS among men and women nonadherent to CRCS visiting FQHCs in Puerto Rico. To test the efficacy of this program on CRCS completion, we will conduct a randomized behavioral intervention trial in 10 FQHC clinics island wide.
Note: This abstract was not presented at the conference.
Citation Format: Camille Velez-Alamo, Adrianna I. Acevedo-Fontanez, Vivian Colon-Lopez, Marievelisse Soto-Salgado, Yolanda Serra-Martinez, Ileska M. Valencia-Torres, Maria E. Fernandez. Development of a tailored interactive multimedia intervention (TIMI) to promote colorectal cancer screening among Puerto Ricans [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C11.