Modave begins NCI training to launch mHealth app for colorectal cancer screening

Photo of Francois Modave
François Modave, PhD

A team of UF researchers including François Modave, Ph.D., has begun an 8-week National Cancer Institute (NCI)-sponsored training designed to help scientists bring their research-tested behavioral interventions into wider use in real-world settings.

The team, led by Janice Krieger, Ph.D., director of the STEM Translational Communication Center (STCC), believes the knowledge and mentoring gained through the program will help them prepare for more widespread dissemination of a customizable virtual human web app they developed to improve screening rates for colorectal cancer. The workshop is offered to researchers with a current R01 funding award with the NCI.

“We believe a culturally sensitive virtual health provider could be used effectively to significantly improve screening rates for colorectal cancer among traditionally underserved populations, such as racial and ethnic minorities and people living in rural areas,” said Modave, an associate professor of biomedical informatics in the Department of Health Outcomes & Biomedical Informatics (HOBI) at UF and director of the department’s mobile health (mHealth) lab.

The app, in which patients visit with a virtual human doctor to discuss the importance of colorectal cancer screening, currently is being tested by patients and physicians at UF Health.

“Broad dissemination of a customizable app that essentially lets you select your health care provider would allow us to reach a much wider audience with our tailored message of screening,” Modave said.

Modave serves as co-investigator of a five-year, $3,045,705 funding award from the National Institutes of Health to develop translational communication tools and interventions aimed at improving cancer control and prevention. Krieger, the grant’s principal investigator, is also a professor in the advertising department in the College of Journalism and Communications at UF and co-director of the recruitment center at UF’s Clinical and Translational Sciences Institute (CTSI).

Other members of the team include Lauren Griffin, Ph.D., a postdoctoral associate at the STCC who will serve as the team’s entrepreneurial lead during the NCI training, and Benjamin Lok, Ph.D., professor in computer and information science and engineering in the Herbert Wertheim College of Engineering at UF. Lok specializes in designing and developing informatics tools for cancer control and prevention. He has spent the past 13 years developing and evaluating mixed reality and virtual reality interfaces.

Colorectal cancer is a major cause of cancer death among American men and women, and racial and ethnic minorities are disproportionately affected. Regular screening for colorectal cancer for patients ages 50 to 75 increases early detection and survival rates. However, many patients face barriers, such as time and monetary constraints. What’s more, primary care physicians don’t always have time to address all the preventive guidelines with their patients or to discuss the most appropriate colorectal cancer screening method for their patients.

Screening rates for colorectal cancer in general are low and currently are not on target to meet the NCI goal of having 80 percent of eligible participants within screening guidelines by 2020, Modave said.

Patients who use the web app enter a virtual office where they answer a series of questions designed to determine their eligibility for colorectal cancer screening and the appropriateness of a home screening test known as fecal immunochemical testing, or FIT. FIT screening involves collecting a stool sample at home and sending it to a laboratory, where it is tested for microscopic blood, which may indicate the presence of a tumor or pre-malignant polyp in the colon.

“The app lets us tailor the message and messenger for each patient based on their medical history,” Modave said. Patients at high risk of developing colorectal cancer, such as those with polyps or a family history, are directed out of the application and encouraged to speak with their health care provider about appropriate screening. Patients without these risk factors receive a series of tailored messages about colorectal cancer and its severity, their susceptibility to the disease, and how home screening using FIT can help them comply with screening guidelines. After completing the visit with the virtual health doctor, patients receive a link enabling them to request a FIT from their primary doctor.

The app can be tailored to match patients with a virtual health doctor who is similar to them in terms of race, ethnicity, and gender, as well.

“This customizability of the app to match the message and virtual health doctor to the patient may increase the likelihood that the patient will process the message and change his or her behavior,” Modave said.

Modave emphasized that the app is not a substitute for a real doctor. However it can be a resource and first line of defense for people who don’t have easy access to medical care or are traditionally underserved.

During the two-month training, the team will conduct face-to-face interviews with a minimum of 40 potential customers and stakeholders.

“We hope to use what we learn from the experimental portion of our research project to further refine and improve the mHealth app,” Modave said.

In addition to conducting the customer interviews, the team will receive 18 hours of training on adapting and translating their interventions into real-world settings, two months of  networking and mentorship to hone their idea and perfect their pitch, and the opportunity to refine the intervention  and receive feedback on how to move forward with dissemination or commercialization.

“We believe that the knowledge and mentoring gained through this program will help us launch our intervention on a larger scale and begin moving toward higher screening rates,” Modave said. The team believes that the technology itself holds the promise of addressing other medical challenges, such as screening for other types of cancer, disseminating vaccine information, and pointing people toward mental health resources.