DESCRIPTION (provided by applicant): An increased susceptibility to colorectal cancer (CRC) has been identified in siblings of individuals diagnosed with CRC prior to age 56. For these individuals at greater than average risk for CRC, guidelines recommend CRC screening starting a decade earlier than for those at average risk individuals (starting at age 35-40). Our prior study of 504 at-risk siblings indicated that approximately 44% of these siblings are not currently compliant with CRC screening guidelines. Guided by the Transtheoretical, Health Belief and Dual Process models, our prior study identified key attitudinal and non-attitudinal predictors of screening behaviors and intentions. The proposed study will use these results to guide the development and evaluation of interventions to improve CRC screening acceptance. The proposed study will evaluate the impact of three interventions to promote CRC screening among siblings in this risk group who are not currently compliant with CRC screening guidelines: 1) a generic print intervention; 2) a tailored print intervention, and; 3) a tailored print plus tailored telephone counseling intervention. Siblings in the tailored print and telephone counseling conditions will receive messages tailored specifically to their responses on targeted attitudinal and non-attitudinal measures. Siblings in the generic print condition will receive a pamphlet about colorectal cancer screening published by the American Cancer Society. Five hundred twenty four siblings meeting eligibility criteria will be randomly assigned to one of the three conditions after a baseline interview assessing CRC screening behaviors and attitudes, and it is anticipated that 427 siblings will complete the study. For siblings in the tailored conditions, baseline information will be utilized to design the tailored messages. After receiving the intervention information, participants will be interviewed again six months later regarding CRC screening behaviors and attitudes to assess the impact of the intervention.