Leveraging Social Media Influencers to Improve Anal Cancer Prevention

Although anal cancer is rare compared to other gastrointestinal cancers, its incidence and mortality have steadily increased over the past several decades. These trends disproportionately affect individuals with certain immunologic and behavioral risk factors, placing specific populations at markedly higher risk. Recent guidelines recommend targeted anal cancer screening based on individual risk, including annual digital anorectal exams (DARE), anal cytology with or without high-risk HPV testing, and follow-up with high- resolution anoscopy (HRA) for abnormal results. Despite effective prevention strategies, awareness remains low, stigma persists, and utilization of preventive services is uneven. This study will develop and evaluate a novel, peer-led social media intervention to promote anal cancer prevention in high-risk populations. Grounded in the Information-Motivation-Behavioral Skills (IMB) model, the Popular Opinion Leader (POL) model, and the SMILE Framework (“Social Media for Implementing Evidence”), the intervention will be co-designed with a community advisory board and delivered by trained influencers. The specific aims are: (1) Co-design and evaluate a peer-led social media influencer training program using adapted materials from a previously tested intervention and an evidence-based anal cancer prevention toolkit; and (2) Assess the feasibility and short- term impact of the resulting social media campaign. Using a mixed methods approach—including engagement metrics, social network analysis, qualitative interviews, and quasi-experimental methods—this study will generate essential data on the feasibility, acceptability, and potential impact of this scalable intervention. The long-term goal is to inform national communication strategies to reduce disparities in anal cancer. Project Number: 1R21CA302024-01A1 | Fiscal Year: 2026 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Christopher Wheldon | Institution: TEMPLE UNIV OF THE COMMONWEALTH, PHILADELPHIA, PA | Award Amount: $407,543 | Activity Code: R21 | Study Section: Health Promotion in Communities Study Section[HPC] View on NIH RePORTER: https://reporter.nih.gov/project-details/11374002