National health communication campaign developers have ignored rural audiences in campaign development and testing, despite the health disparities that exist for this group. Researchers in a rural Midwestern state tested the appropriateness of CDC's national colorectal cancer screening campaign, Screen for Life. Based on focus groups and a quasiexperimental design evaluation, researchers determined that the national campaign did not adequately address the needs of the rural audience. A new print and radio campaign was developed based on previous findings, grounded in social marketing and the health belief model. New tailored campaign materials were refined in focus groups. Final versions were tested in two quasiexperimental designs. Results support the campaign's reach and efficacy. Those in the intervention county were significantly more likely than the unexposed to (a) report recent exposure to ads, (b) plan to seek out information regarding screening, and (c) plan to get screened in the near future. (Contains 2 tables.)