The first 15 years: what has been learned about the Cancer Information Service and the implications for the future.

The Cancer Information Service (CIS) has been in existence for over 15 years. During that period, lessons have been learned that have been used to increase the effectiveness of the network. This paper lists 12 of those lessons, covering issues such as giving sophisticated medical information; reaching diverse target audiences; using the mass media; developing systems needed for quality assurance, research, and information technology; and nurturing a local-national partnership. The paper also discusses major accomplishments of the program and lists recommendations for meeting the challenges to be faced by the CIS in the future.

Effect of the mass media in promoting calls to the Cancer Information Service.

The Cancer Information Service is a toll-free telephone inquiry service that provides information about cancer and related resources to the public, patients and their families, and health-care providers. The service was created in 1975 to provide rapid access to the latest information about cancer, to address specific population needs, and to bridge gaps between cancer research and application. This article reviews a variety of ways in which the mass media have been used to promote calls to the Cancer Information Service. Conclusions are drawn about the usefulness of media promotion in the past, and recommendations are suggested for future media promotion of the service.

Outreach programs and their effects within the Cancer Information Service network.

Outreach programs have been part of the Cancer Information Service (CIS) program since its outset. The scope of work of the first two CIS contracts gave broad responsibilities to the local offices for public and professional education, responsibilities that were carried out in a diverse fashion with little national direction. As the National Cancer Institute (NCI) Office of Cancer Communications matured and became more directed, the CIS local offices began successfully to implement programs with the Office of Cancer Communications and through intermediary groups. The Partners in Prevention (PIP) effort, launched by NCI in 1984, was the first major national community education program in which all the CIS offices participated. Shortly after the inception of PIP, however, the outreach personnel were deleted from the CIS contracts, due to budget restrictions. When the outreach component was reinstituted in 1990, the structure of the program changed to a catalytic role, working with local media and intermediary organizations to bring the NCI program messages and materials to targeted audiences and memberships. Under the reconfigured CIS network, the outreach program will serve as a resource to both those community institutions that are funded by NCI and those that are not and will be proactive in intermediary development. This paper details the chronology of the program and presents some of the research issues that need to be addressed in the future.

History of the Cancer Information Service.

The Cancer Information Service (CIS) was established on July 1, 1975, following the mandate of the National Cancer Act of 1971 giving the National Cancer Institute (NCI) new responsibilities for educating the public, patients, and health professionals. Funded under a contract mechanism, the CIS has become one of the longest-running community programs in NCI. The CIS has been able to set up and maintain high-quality service, giving accurate, up-to-date medical information to cancer patients and their families and friends, to health professionals, and to the general public. The CIS network, which has taken more than 5 million calls since its inception, has weathered many changes, both at the national and the local level. Its current call volume, in excess of 500,000 calls per year, makes it one of the most heavily utilized health-related telephone helplines in the country. Using a standardized Call Record Form, data on calls have been recorded consistently since 1983; the dataset now contains information on more than 4.2 million calls. An outreach component that acts as NCI's field arm has been part of the CIS since its inception. The CIS has matured into a stable system that has been reconfigured into 19 regional offices, covering the entire country. These offices run the telephone service and serve as NCI's outreach arm, working with intermediaries to carry out NCI information and education programs in local communities.

Channels and vehicles of communication: the asbestos awareness campaign.

In April 1978, the U.S. Department of Health, Education, and Welfare launched a multimedia campaign to inform doctors, workers, and others about the increased risks of asbestos exposure. Unlike most worker notification efforts, this one has no lists of workers or even of workplaces but faced the challenge of locating people who had worked in the shipbuilding industries more than 30 years earlier. Multiple mass media channels were used, but since most messages were distributed as public service announcements, gatekeepers were critical to the success of the campaign. Some campaign messages were aired, but mostly at hours other than prime time, and the coverage focused more on the controversial, fast-breaking events rather than on estimates of risk or on behaviors to reduce risk. The campaign was effective in increasing the number of people who believed they were at risk, but was less successful with older Americans than with manual laborers.