The goal of this study is to run a pilot test to disseminate a successful CISRC Program Project intervention (tailored print materials for increasing fruit and vegetable consumption) within the NCI Cancer Information Service (CIS) 1-800-4-CANCER answerline.

cancer prevention, diet, nutrition, fruit, vegetables, dissemination, tailored, print materials, telecounseling, CIS, 5-a-day

1. Transfer all intervention products (e.g., tailoring engine with message library) to CIS Central Support (CISCS), which will be the organization (under contract to the CIS) that will implement the 5-A-Day intervention as a usual service program.
   
2. Train CISCS staff to implement the usual service intervention; beta test the intervention prior to dissemination.
3. Conduct a vanguard dissemination study of the 5-A-Day intervention involving six CIS offices nationwide.
   
4. Evaluate the intervention, focusing mainly on process evaluation and implementation fidelity.
   
5. Contingent upon the results obtained from the vanguard dissemination study, implement the 5-A-Day intervention as a usual service program within the CIS, coinciding with three (annual) national promotions of the 5-A-Day program.

1,022 individuals who call NCI's Cancer Information Service.

This pilot study disseminates a longitudinally tailored print intervention to promote the 5 A Day for Better Health program among callers to the National Cancer Institute's Cancer Information Service (CIS).

At the end of usual care services, callers are asked if they would like to participate in a study to learn more about how to increase their fruit and vegetable consumption. Following a baseline telephone interview, which includes a brief educational message (BEM), participants are assigned randomly within CIS offices to one of four groups:

• single untailored (SU) group: receive one set of untailored materials immediately.
• single tailored (ST) group: receive one tailored booklet immediately.
• multiple tailored (MT) group: receive four tailored materials over time, immediately, 5 months, 8 months, 11 months. All tailoring based on baseline data.
• multiple retailored (MRT) group: receive four tailored materials over time. The first tailored material is based on baseline data. The 5, 8, and 11 month materials are based on 5-month follow-up interview data.

Process and evaluation data are collected at follow-up phone calls made at 5 and 12 months.

Program evaluation focused on process and implementation evaluation, including adherence to the baseline interviews by CIS information specialists based on live-call monitoring (n = 55 eligible callers), and the timeliness of the intervention mailouts (4,088 scheduled mailouts).

• Adherence to the baseline interviews by CIS information specialists was extremely high, exceeding 90% for all indicators of quality control.
  
• Of the 4,088 intervention mailings, 75% occurred on or before the target date, while 95% occurred within 21 days of the target date.
  
• All delays in the scheduled mailouts occurred in the first mailing, due to changes made in the production process (batch printing of all tailored print materials at baseline). This change required additional system upgrades and more intensive and time-consuming quality control than originally anticipated, which was exacerbated by the faster-than-expected accrual of eligible participants.

Based on this pilot study, the CIS is now positioned for widespread dissemination of the 5 A Day tailored print intervention. Several key lessons learned are also identified to facilitate the transition from research to dissemination.

Marcus AC, Heimendinger J, Berman E, Strecher V, Bright MA, Allen AR, Davis SW, Julesberg K, Mowad LZ, Perocchia R, and Thomsen C. A case study in dissemination: Lessons learned from a pilot study involving the National Cancer Institute’s Cancer Information Service. Journal of Health Communication, 2005 10(Supplement 1): 219-224.<br><br>

Heimendinger J, O’Neill C, Marcus AC, Wolfe P, Julesburg K, Morra M, Allen A, Davis S, Mowad L, Perocchia R, Ward JD, Strecher V, Warnecke R, Nowak M, Graf I, Fairclough D, Bryant L, and Lipkus I. Multiple tailored messages are effective in increasing fruit and vegetable consumption among callers to the Cancer Information Service. Journal of Health Communication, 2005 10(Supplement 1): 65-82.