Abstract
Patients facing decisions for breast cancer surgery commonly search the internet. Directing patients to high-quality websites prior to the surgeon consultation may be one way of supporting patients’ informational needs. The objective was to test an approach for delivering web-based information to breast cancer patients. The implementation strategy was developed using the Replicating Effective Programs framework. Pilot testing measured the proportion that accepted the web-based information. A pre-consultation survey assessed whether the information was reviewed and the acceptability to stakeholders. Reasons for declining guided refinement to the implementation package. Eighty-two percent (309/377) accepted the web-based information. Of the 309 that accepted, 244 completed the pre-consultation survey. Participants were a median 59 years, white (98%), and highly educated (>50% with a college degree). Most patients who completed the questionnaire reported reviewing the website (85%), and nearly all found it helpful. Surgeons thought implementation increased visit efficiency (5/6) and would result in patients making more informed decisions (6/6). The most common reasons patients declined information were limited internet comfort or access (n = 36), emotional distress (n = 14), and preference to receive information directly from the surgeon (n = 7). Routine delivery of web-based information to breast cancer patients prior to the surgeon consultation is feasible. High stakeholder acceptability combined with the low implementation burden means that these findings have immediate relevance for improving care quality.
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References
Fox S, Duggan M. Health Online 2013. http://www.pewinternet.org/2013/01/15/health-online-2013/. Accessed 14 Mar 2016
Hamilton SN, Scali EP, Yu I, Gusnowski E, Ingledew PA (2015) Sifting through it all: characterizing melanoma patients’ utilization of the internet as an information source. J Cancer Educ 30(3):580–584
McLeod J, Yu I, Ingledew PA (2016) Peering into the deep: characterizing the internet search patterns of patients with gynecologic cancers. J Cancer Educ
Nguyen SK, Ingledew PA (2013) Tangled in the breast cancer web: an evaluation of the usage of web-based information resources by breast cancer patients. J Cancer Educ 28(4):662–668
van Deursen AJ, van Dijk JA (2011) Internet skills performance tests: are people ready for eHealth? J Med Internet Res 13(2):e35
Bruce JG, Tucholka JL, Steffens NM, Neuman HB (2015) Quality of online information to support patient decision-making in breast cancer surgery. J Surg Oncol 112(6):575–580
Goslin RA, Elhassan HA (2013) Evaluating internet health resources in ear, nose, and throat surgery. Laryngoscope 123(7):1626–1631
Neuman HB, Cabral C, Charlson ME, Temple LK (2007) Is internet information adequate to facilitate surgical decision-making in familial adenomatous polyposis? Dis Colon rectum 50(12):2135–2141
Wasserman M, Baxter NN, Rosen B, Burnstein M, Halverson AL (2014) Systematic review of internet patient information on colorectal cancer surgery. Dis Colon rectum 57(1):64–69
Kohler BA, Sherman RL, Howlader N, et al. (2015) Annual report to the nation on the status of cancer, 1975–2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst 107(6):djv048
Mandelblatt J, Kreling B, Figeuriedo M, Feng S (2006) What is the impact of shared decision making on treatment and outcomes for older women with breast cancer? J Clin Oncol 24(30):4908–4913
Holmes-Rovner M, Valade D, Orlowski C, Draus C, Nabozny-Valerio B, Keiser S (2000) Implementing shared decision-making in routine practice: barriers and opportunities. Health Expect 3(3):182–191
O’Connor AM, Llewellyn-Thomas HA, Flood AB (2004) Modifying unwarranted variations in health care: shared decision making using patient decision aids. Health Aff (Millwood). Suppl Variation:VAR63–72
Belkora JK, Miller MF, Dougherty K, Gayer C, Golant M, Buzaglo JS (2015) The need for decision and communication aids: a survey of breast cancer survivors. J Community Support Oncol 13(3):104–112
Hack TF, Degner LF, Parker PA (2005) The communication goals and needs of cancer patients: a review. Psychooncology 14(10):831–845 discussion 846-837
Tomoaia-Cotisel A, Scammon DL, Waitzman NJ et al (2013) Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change. Ann Fam Med 11(Suppl 1):S115–S123
Waltz TJ, Powell BJ, Matthieu MM et al (2015) Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study. Implement Sci 10(1):109
Kilbourne AM, Neumann MS, Pincus HA, Bauer MS, Stall R (2007) Implementing evidence-based interventions in health care: application of the replicating effective programs framework. Implement Sci 2:42
Singh GK (2003) Area deprivation and widening inequalities in US mortality, 1969-1998. Am J Public Health 93(7):1137–1143
Kind AJ, Jencks S, Brock J et al (2014) Neighborhood socioeconomic disadvantage and 30-day rehospitalization: a retrospective cohort study. Ann Intern Med 161(11):765–774
O’Connor AM, Cranney A. User manual—acceptability. 1996. http://decisionaid.ohri.ca/docs/develop/User_Manuals/UM_Acceptability.pdf. Accessed 12 July 2013
Lee CJ, Ramírez AS, Lewis N, Gray SW, Hornik RC (2012) Looking beyond the Internet: examining socioeconomic inequalities in cancer information seeking among cancer patients. Health Commun 27(8):806–817
Perrin A, Duggan M (2015) Americans’ Internet access: 2000–2015. Pew Research Center
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Eligible patients were then offered the study by the nursing staff or breast cancer navigator either at the time of diagnosis or when their appointment in the surgery clinic was made, and oral consent was obtained. The study protocol was approved by the UW Human Subjects Committee and all participants gave informed consent.
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The project was funded by the Building Interdisciplinary Research Careers in Women’s Health Scholar Program (NIH K12 HD055894). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. It was also supported in part by the University of Wisconsin Carbone Cancer Center through NIH/NCI P30 CA014520- UW Comprehensive Cancer Center Support and the Mentored Training for Dissemination and Implementation Research in Cancer fellowship (R25CA171994).
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Bruce, J.G., Tucholka, J.L., Steffens, N.M. et al. Feasibility of Providing Web-Based Information to Breast Cancer Patients Prior to a Surgical Consult. J Canc Educ 33, 1069–1074 (2018). https://doi.org/10.1007/s13187-017-1207-6
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DOI: https://doi.org/10.1007/s13187-017-1207-6