DESCRIPTION (provided by applicant): Compared to other racial groups, African Americans have the highest colorectal cancer (CRC) morbidity and mortality rates. Although colonoscopies can prevent CRC, nearly half of African Americans (40.2%) have not received a screening colonoscopy within the recommended time frame (one colonoscopy per ten years). It is critical to increase African Americans' screening colonoscopy rates in order to reduce racial inequities in CRC morbidity and mortality. Dr. Miller's pilot work, as well as the current literature, suggest that an Internet-based Motivational Interviewing Intervention for Colonoscopy (I-MIIC) may help improve African Americans' screening colonoscopy uptake. The proposed project will first field-test the intervention, using an iterative approach, with African Americans referred for a screening colonoscopy (N=40). The field-testing results will guide the development, revisions, and finalization of the I-MIIC. Then, a randomized clinical trial will examine the efficacy of the -MIIC for improving African Americans' screening colonoscopy uptake. Participants (N=200) will be randomly assigned to an intervention group (N=100) in which they engage in a 20-minute I-MIIC intervention or a control group (N=100) in which they review a print brochure on CRC screening. The results will contribute to the growing literature on CRC disparities. Dr. Sarah Miller is the ideal candidate to spearhead this line of research given her academic and clinical background in CRC disparities and motivational interviewing. Dr. Miller's long-term goal is to become an independent researcher with expertise in the early detection and prevention of cancer in racial/ethnic minorities. To achieve her goals, as part of the K07, Dr. Miller will receie intensive training in four areas: 1) qualitative research; 2) e-Health; 3) longitudinal data analyss, and 4) professional development. The K07 will provide Dr. Miller with a variety of avenues to achieve her training goals and enhance her expertise. In particular, Dr. Miller will have ongoing meetings with seasoned mentors as well as participate in formal coursework, workshops, conferences, and interactive trainings. The proposed K07 will form the foundation for a program of research that focuses on improving cancer screening uptake in racial/ethnic minorities with the goal of reducing disparities. At the end of the K07 funding period, Dr. Miller will submit an R01 application, based on the results of the present study. The Icahn School of Medicine at Mount Sinai (ISMMS) is the ideal environment for Dr. Miller to complete her proposed research project and training. In particular, the ISMMS can offer Dr. Miller: 1) the resources necessary to complete her research; 2) access to multiple training activities; and 3) access to a diverse patient population. Most importantly, Dr. Miller will receive guidance from a team of superior mentors with expertise in: CRC disparities, qualitative research, biostatistics, e-Health, and primary care. The mentoring team will work closely with Dr. Miller to ensure that she achieves her research and training objectives. Overall, the K07 will provide Dr. Miller with the research experience, intensive training, and mentorship needed to become a successful independent researcher.

PUBLIC HEALTH RELEVANCE: The proposed research has significant public health relevance. The development of an Internet-based motivational interviewing intervention for colonoscopy (I-MIIC) to increase African Americans' screening colonoscopy uptake will help to reduce disparities in colorectal cancer incidence and mortality rates. If the I- MIIC proves efficacious, there is a strong argument to replicate this intervention with other vulnerable populations and with other cancer tests.