PROJECT SUMMARY/ABSTRACT Lung cancer screening is recommended by the U.S. Preventive Services Task Force (USPSTF), has the potential to detect lung cancer at earlier, more treatable stages. However, population uptake of lung cancer screening has been abysmal. It has been 7 years since the USPSTF released its official recommendation, yet less than 5% of screening-eligible Americans have been screened. Screening-eligible individuals are generally unaware about the option of finding lung cancer early through screening, and our team’s prior work revealed that in addition to lack of awareness, screening-eligible individuals in the U.S. do not screen – when they are aware – because of perceived barriers to screening. If high-risk patient populations are not aware that lung cancer screening exists, then formative work is needed to increase awareness about screening. It is essential to employ novel community-focused strategies to increase awareness about lung cancer screening to reach diverse, screening-eligible individuals who might not otherwise learn about the option to screen. Our long term goal is to increase screening uptake among appropriate, high-risk individuals nationwide. Our overall objective in this application is to test the effectiveness of: 1) leveraging a social media-based platform to reach screening-eligible individuals in the community upstream before they engage with the healthcare system, and 2) a novel, tailored health communication and decision support intervention related to lung cancer screening (LungTalk). Our central hypothesis is two-fold: 1) Facebook targeted advertisement will be a successful platform to reach high-risk individuals unaware of lung cancer screening; and 2) tailored compared to non- tailored lung cancer screening information will increase knowledge and improve health beliefs about screening and subsequent screening uptake. Our study is informed by our prior studies, which led us to consider the importance of increasing awareness and knowledge on a population level from the screening-eligible individuals’ perspective as a precursor to health behavior change. Successful use of Facebook to recruit screening-eligible individuals in our prior studies also led us to consider how social media might be used to increase awareness of lung cancer screening and as a platform to link the screening-eligible individual with a tailored health communication and decision support intervention that has the potential to influence screening behavior and uptake. Using a randomized controlled trial design, we will randomize 500 screening-eligible individuals recruited through Facebook nationwide to receive either a tailored intervention (LungTalk) or non- tailored ACS Lung Screening Informational Video. Specific aims are to (1) examine the use of a social media platform to reach high-risk individuals eligible for lung screening; (2) compare the effectiveness of a computer- tailored health communication tool to a web-based ACS Lung S...