1. Michael A. Diefenbach, Ph.D. & Kevin Durr Mount Sinai School of Medicine & notsoldseparately.com LLC

2. An app designed to make cancer screening and its decision-making process simple and reliable

4. Background Early detection is an important component to the Nation’s cancer control efforts. However: Not every person benefits from screening Screening can be distressing Not all cancer screening procedures reduce Ca mortality Screening recommendations vary across organizations Thus, patients need to be informed about their options involved in the screening decision process

5. Aims of the App Provide tailored cancer screening recommendations based on recorded cancer family history and demographic variables Educate users about screening procedures & cancer prevalance & mortality data by US state Provides Pros and Cons of screening Provide decision tool to aid in the decision making process Testimonials from people who did/did not screen Provide action plan to assist in identifing physicians, communicating ones decision to provider, provide information about screening for the non-insured Provide reminders about screening appointments Offers mental health resources for emotional distress

6. Theoretical Framework Self-regulation framework guides the development. SLR has these key elements Cancer relevant expectations, beliefs, including self-efficacy beliefs and beliefs about screening and treatment Cancer relevant affective states Perceived competencies The app will speak to each of these 3 key components, by: Addressing beliefs and expectations Providing reassuring messages and resources to cope with distress Offering detailed action plans

7. Development of the App A prototype of the app will be shown to members of the target audience via focus groups: Men and women eligible for prostate and breast cancer screening Women eligible for cervical cancer screening We will invite a diverse group of men and women, representing different ages, races, and socio-economic backgrounds. Focus groups will be transcribed and coded. App will be revised based on focus group results.

8. Usability Testing of the App Men and women from target audience will be asked to use the app Use talk-aloud method (i.e., ask users to describe what they want to do with the app and record their successes and failures while using the app) Revise app according to changes of usabiity testing Launch HealthOwl

9. HealthOwl on these Platforms The app will be available: on the web On mobile platforms iPhone, Android, Blackberry & Windows Phone 7, and the Web (Internet Explorer, Chrome, Firefox, Safari )

10. Use of public available data Screening recommendations and screening information will be generated from NCI’s PDQ and Medline+. Prevelance data by state and county level for all major cancers from http://statecancerprofiles.cancer.govhttp://statecancerprofiles.cancer.gov

11. Two ways to obtain tailoring data 1) User input answering a few questions about Family history of cancer Sex Age Race/ethnicity Insurance 2) Data input through EPIC. Connect the App via a website to EPIC and relevant data will be transferred into the program.

13. Simple User Input of Basic Demographic Variables Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

14. Add Family History information Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

15. Summary of Family History and Your Screening Options Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

16. The Prostate Cancer Screen Prostate Cancer Screen: Learn facts about prostate cancer Know Pros and Cons of screening Rate the importance of Pros & Cons Receive a summary score of the importance rating Read patient stories Find resources for emotional distress Find a health care provider for screening Invite a family member to also get screened Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

17. Prostate Cancer Facts Here the user finds: Facts about the prostate and its function Information about screening procedure and potential side-effects up-to-date prostate cancer prevelance and mortality data for the user’s state from http://statecancerprofiles.cancer.gov http://statecancerprofiles.cancer.gov Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

18. Pros and Cons About Screening User can read Pros and Cons re prostate cancer screening, e.g.,: PRO: Prostate screening can help find prostate cancer at an early stage. Then a decision has to be made whether it should be treated or observed. CON: Researchers have not demonstrated that earlier treatment prolongs or saves lives Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/

19. Help with Decision—Value Clarification User rates each of the Pros & Cons according to their perceived importance (1=not important; 5=very important) Users receive a summary score and an interpretative statement about their screening intentions

20. Patient stories Based on our work with prostate cancer patients, these stories represent aggregated opinions by men about their experience with prostate cancer screening.

21. Coping with Uncertainties The goal is to provide reassurance about the screening procedure and emotional support to those worried about detecting cancer. Use of GPS to deliver tailored resources Provide resources: Cancer Information Service (1- 800-4Cancer) American Cancer Society (Man to man support group) State-specific resources: e.g. for New York www.newyorkprostate.com

22. Finding a doctor An action plan is an important factor in translating intentions into screening. This pages helps patients find a physician who would conduct the screening based on their health insurance. It also provides resources for those who are not insured.

23. Set a reminder for your screening appointment The unique part of HealthOwl is the ability to set screening appointments as recurring events in the future. Create reminders to create an appointment and for the screening itself Prior to a scheduled date a reminder email and/or a text message will be sent to the user.

24. Connecting to family members Share this app with family members and friends or email or text the link of the HealthOwl site. This is a good way for family and friends to learn about cancer screening.

25. HealthOwl -- Innovation through 4 “Firsts” 1. Informs patients about their screening options, tailored according to their age, race, gender, and family history of cancer; 2. Supports and assists patients in their cancer screening decision making through information and value clarification; 3. Identifies health care providers and facilities; 4. Provides reminders for current and future screening events.

26. Significance and Impact Proposed App Addresses important priorities within the cancer continuum Theory and evidence-based Includes comprehensive disease and screening-related information Lists of cancer related pros and cons Emotionally reassuring messages and resources for those who are worried Action plan (find a doctor, regardless of insurance status; get emotional support)

27. HealthOwl Get Empowered. Make smart choices. www.healthowl.org Michael Diefenbach – Team Leader and co-founder Michael.diefenbach@mountsinai.org Kevin Durr – Senior Architect and co-founder– Kevin@notss.com Mayr Budny – User Interface Director mbudny@notss.com Visit http://www.healthowl.org/tour/ to watch an interactive video tour of our prototypehttp://www.healthowl.org/tour/ A proven team Our team has worked together for over 5 years building interactive cancer education and decision aids interventions