Aim 1. Develop a tailored colon cancer screening education website and link the site to the patient portal under development at two University of Michigan primary care study sites.

Aim 2. Promote the web-based tailored colorectal cancer information program to patients age 50 or older within a primary care health delivery system.

Aim 3. Quantify the numbers of patients using the site, their demographic characteristics, and changes in their knowledge, attitudes, and intent to screen after viewing the website.

Aim 4. Quantify differences in the knowledge, attitudes, intentions, and self-reported screening practices between patients who were given access to the site and those who were not.

Aim 5. Quantify the differences in the actual use of screening-related procedures between patients given access to the site versus those who did not have access, using the Clinical Data Repository (CDR) of the university of Michigan to gather utilization data.

120 recent patients of internal or family medicine clinics.

Ten focus groups and 30 individuals (completing in-depth interviews) are asked to review and provide feedback about an initial version of the ColoWeb website as well as existing CRC screening websites available on the Internet.

Each focus group and individual are asked open-ended questions about each website's interface, its ease of use, the content, and how it might be improved. These discussions are audio taped and transcribed for analysis. Individuals also go through in-depth interviews.

We conducted 10 focus groups and searches of existing Web sites in preparation for developing a Web site about colorectal cancer (CRC) screening. We conducted 30 in-depth interviews to assess content, navigation, and usability of a new CRC Web site, using participants recruited from Michigan communities with a low incidence of CRC testing.

Existing CRC screening Web sites uniformly use user-directed navigation and have little variation in content. Our study participants stimulated revisions in content, navigation, and usability. Revised content factors included comprehension, utility, and appeal. Navigation changes focused on logical transition between sections. Usability changes included user focus and clarity of graphics/text.

We found focus groups, Web site searches, and individual interviews useful in developing and testing content, navigation, and usability of a CRC screening Web site. These steps provide methodological procedures for developing and revising health-related Web sites.