Article

Effect of Computer Support on Younger Women with Breast Cancer

National Black Leadership Initiative on Cancer, University of Illinois at Chicago, Chicago, Ill (FMA)
Journal of General Internal Medicine (Impact Factor: 3.42). 12/2001; 16(7):435 - 445. DOI: 10.1046/j.1525-1497.2001.016007435.x
Source: PubMed

ABSTRACT OBJECTIVE: Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved.DESIGN: Randomized controlled trial conducted between 1995 and 1998.SETTING: Five sites: two teaching hospitals (Madison, Wis, and Chicago, Ill), two nonteaching hospitals (Chicago), and a cancer resource center (Indianapolis, Ill). The latter three sites treat many underserved patients.PARTICIPANTS: Newly diagnosed breast cancer patients (N = 246) under age 60.INTERVENTIONS: Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support.MEASUREMENTS AND MAIN RESULTS: Pretest and two post-test surveys (at two- and five-month follow-up) measured aspects of participation in care, social/information support, and quality of life. At two-month follow-up, the CHESS group was significantly more competent at seeking information, more comfortable participating in care, and had greater confidence in doctor(s). At five-month follow-up, the CHESS group had significantly better social support and also greater information competence. In addition, experimental assignment interacted with several indicators of medical underservice (race, education, and lack of insurance), such that CHESS benefits were greater for the disadvantaged than the advantaged group.CONCLUSIONS: Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.

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    • "There have been several studies linking participation in online cancer social support intervention with behavioral and or health status outcomes including participation in health care, depression, and stress (Gustafson et al., 2001; Winzelberg et al., 2003; Wise, Han, Shaw, McTavish, & Gustafson, 2008). Some of these authors and others have examined the links between what is being said during these interactions and outcomes. "
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    ABSTRACT: The Internet has been used extensively to offer health education content and also for social support. More recently, we have seen the advent of Internet-based health education interventions that combine content with structured social networking. In many ways this is the Internet equivalent to small group interventions. While we have some knowledge about the efficacy of these interventions, few studies have examined how participants engage with programs and how that might affect outcomes. This study seeks to explore (a) the content of posts and (b) the nature of participant engagement with an online, 6-week workshop for cancer survivors and how such engagement may affect health outcomes. Using methodologies related to computational linguistics (latent Dirichlet allocation) and more standard statistical approaches, we identified (a) discussion board themes; (b) the relationship between reading and posting messages and outcomes; (c) how making, completing, or not completing action plans is related to outcome; and (d) how self-tailoring relates to outcomes. When considering all posts, emotional support is a key theme. However, different sets of themes are expressed in the first workshop post where participants are asked to express their primary concern. Writing posts was related to improved outcomes, but reading posts was less important. Completing, but not merely making, action plans and self-tailoring are statistically associated with future positive health outcomes. The findings from these exploratory studies can be considered when shaping future electronically mediated social networking interventions. In addition, the methods used here can be used in analyzing other large electronically mediated social-networking interventions.
    Health Education &amp Behavior 10/2014; 42(1). DOI:10.1177/1090198114550822 · 1.54 Impact Factor
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    • "A trained facilitator moderates discussions to ensure that discussions are supportive and do not contain inaccurate or harmful information. The data used in this study were collected as part of a larger randomized clinical trial to examine different component parts of the CHESS ''Living with Breast Cancer'' intervention (Gustafson et al., 2001). "
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    ABSTRACT: This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.
    Computers in Human Behavior 01/2014; 30:13-22. DOI:10.1016/j.chb.2013.07.024 · 2.69 Impact Factor
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    • "The participants were at or below 250% of the federal poverty level -not homeless -within 1 year of diagnosis with early-stage breast cancer or metastatic breast cancer. The 4-month intervention was implemented with the assumption that the CHESS intervention effects would occur at least after 2 months of the intervention (see Gustafson et al., 2001, 2005, 2008). Of 341 eligible patients who were initially recruited, 286 completed the study. "
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    ABSTRACT: This study attempts to examine the role of social support perception and emotional well-being on online information seeking among cancer patients within the context of CHESS, a well-established Interactive Cancer Communication System (ICCS). Factor and regression analyses conducted among 231 breast cancer patients revealed that social support perception and emotional well-being interacted with each other to influence online health information seeking. Patients with low social support perception and high emotional well-being were most likely to seek health information, whereas patients with high social support perception and high emotional well-being sought out the same information least. Practical implications of the study findings were further discussed.
    Journal of Computer-Mediated Communication 01/2013; 18(2):98-118. DOI:10.1111/jcc4.12002 · 2.17 Impact Factor
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