Using Social Media to Reduce Multiple Risk Factors for CRC in Rural Appalachians: #CRCFREE

Purpose: To examine the efficacy, acceptability, feasibility, and applicability of a Facebook (FB) intervention designed to reduce multiple colorectal cancer (CRC) risk factors in older adults residing in rural Appalachian Kentucky. Methods: We piloted a 12 week FB intervention culturally tailored for older adults residing in rural Eastern Kentucky to impact CRC risk factors, including: nutrition, physical activity, and screening. Participants were aged 50+, had internet access, and were at risk for CRC. During the 12 week study, the participants received three daily posts via secret FB group regarding CRC risk factors. Demographics, dietary measures, body mass index (BMI), and CRC screening were assessed at baseline and post intervention. FB engagement and physical activity were tracked throughout the intervention. Dietary measures included the Healthy Eating Index (HEI) and Dietary Inflammatory Index (DII). Physical activity was tracked using Fitbits. Post-intervention focus group interviews were conducted to assess feasibility and acceptability. Results: Participants (n = 57) were Caucasian, aged 58 ± 6 years, predominately female (67%), and the majority reported at least a high school education (77%). Post intervention, participants experienced significant increase in HEI scores (49.94 ± 9.84 vs. 58.60 ± 12.06, P = < 0.01). DII scores significantly decreased (2.44 ±1.12 vs. 1.60 ± 1.63, P = 0.003). There was no significant change in physical activity, BMI, or screening status. Participants, on average, viewed more than half of the posts. Focus group participants found FB posts to be useful and motivating. They reported that FB posts were educational and motivational. Conclusion: This pilot study shows promising preliminary data to support using a FB intervention in rural Appalachian older adults to decrease CRC risks. Participants were receptive to FB intervention, and FB provides a unique and accessible method for health promotion in hard to reach populations.

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