title: Effect of computer support on younger women with breast cancer.
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.
  
  
  METHODS
  Randomized controlled trial conducted between 1995 and 1998.
  
  
  METHODS
  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.
  
  
  METHODS
  Newly diagnosed breast cancer patients (N = 246) under age 60.
  
  
  METHODS
  Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support.
  
  
  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.
authors.affiliation: Department of Industrial Engineering, University of Wisconsin-Madison, Madison, WI 53705, USA. dhgustaf@facstaff.wisc.edu
authors.forename: D H
authors.initials: DH
authors.lastname: Gustafson
authors.forename: R
authors.initials: R
authors.lastname: Hawkins
authors.forename: S
authors.initials: S
authors.lastname: Pingree
authors.forename: F
authors.initials: F
authors.lastname: McTavish
authors.forename: N K
authors.initials: NK
authors.lastname: Arora
authors.forename: J
authors.initials: J
authors.lastname: Mendenhall
authors.forename: D F
authors.initials: DF
authors.lastname: Cella
authors.forename: R C
authors.initials: RC
authors.lastname: Serlin
authors.forename: F M
authors.initials: FM
authors.lastname: Apantaku
authors.forename: J
authors.initials: J
authors.lastname: Stewart
authors.forename: A
authors.initials: A
authors.lastname: Salner
mesh_terms: D000328:Adult; D001741:Black or African American; D001943:Breast Neoplasms / Q000208:ethnology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007255:Information Services; D016014:Linear Models; D008507:Medically Underserved Area; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D011788:Quality of Life; D012944:Social Support