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Background In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men. Objective This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention. Methods A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents. Results A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively. Conclusions Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge–based intervention into a digital, self-paced, tailored intervention with links to local community clinics. Trial Registration ClinicalTrials.gov NCT05980182; https://clinicaltrials.gov/study/NCT05980182
Background In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men. Objective This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention. Methods A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents. Results A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively. Conclusions Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge–based intervention into a digital, self-paced, tailored intervention with links to local community clinics. Trial Registration ClinicalTrials.gov NCT05980182; https://clinicaltrials.gov/study/NCT05980182
UNSTRUCTURED In the US Colorectal Cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other race/ethnicities Black men have the lowest rates of CRC screening participation, which contributes to later stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for CRC screening in Black men. The purpose of this study was to report on the multi-step process used to translate prior experiences implementing a national CRC education program into a culturally tailored mHealth intervention. This intervention is designed to increase CRC screening among Black men in a Virginia city with one of the highest CRC incidence and mortality rates in the US. This translational science public health intervention is theoretically and empirically informed, and proposes a unique delivery method to improve reach. The following details the design process and implementation plan including description of milestones in the development process, relationship development with community and clinical partners, and plan for implementation and evaluation.
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