title: Evaluating participants' use of a hormone replacement therapy decision-making intervention.
abstract: BACKGROUND
  Associations between optimal use of a tailored decision-aid and levels of accuracy of perceived breast cancer risk, confidence in decision-making, and satisfaction with decisions about HRT were evaluated in a randomized intervention trial with a community sample of women aged 45-54.
  
  
  METHODS
  Data are from 289 women randomized to receive a computer-tailored three-step decision-aid.
  
  
  RESULTS
  Forty-seven percent of participants reported optimal use of the intervention materials. African American women and those with low confidence in decision-making were less likely to use the intervention optimally than white women and those with higher confidence (P<0.05). Optimal use of the decision-aid was associated with increased accuracy of perceived risk and confidence to make a decision.
  
  
  CONCLUSIONS
  When used optimally, self-directed decision-aids can improve women's ability to make decisions about HRT. Additional refinement of these aids is needed. For some subgroups of women, adjuncts such as telephone counseling also might be considered.
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street (152), Durham, NC 27705, USA. basti001@mc.duke.edu
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McBride
authors.forename: Laura
authors.initials: L
authors.lastname: Fish
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.forename: David
authors.initials: D
authors.lastname: Farrell
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Lipkus
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.forename: Ilene C
authors.initials: IC
authors.lastname: Siegler
mesh_terms: D001741:Black or African American / Q000193:education / Q000523:psychology; D003194:Computer-Assisted Instruction / Q000592:standards; D003376:Counseling; D003658:Decision Making, Computer-Assisted; D003661:Decision Support Techniques; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009657:North Carolina; D010353:Patient Education as Topic / Q000592:standards; D010358:Patient Participation; D017698:Postmenopause / Q000523:psychology*; D020377:Self Efficacy; D044465:White People / Q000193:education / Q000523:psychology; D014930:Women / Q000193:education / Q000523:psychology*