title: Use and evaluation of an individually tailored website for counselees prior to breast cancer genetic counseling.
abstract: This article explores the use and evaluation of a pre-visit website which aims to prepare counselees who are the first in their family to request breast cancer genetic counseling. This website E-info gene(ca) provides computer-tailored information and a blank question prompt sheet (QPS) on which counselees can formulate their questions for the consultation. The objectives of this study are: first, to assess which factors influence the use of E-info gene(ca), including the duration of site and page views, the influence of topic sequence in the menu bar on the sequence of page views, and the relation between website use and the use of the QPS; second, to explore counselees' evaluations of E-info gene(ca) and relations with counselee characteristics. User statistics were analyzed to describe duration of site and page views. Multivariate analyses were used to predict duration of web and page views, sequence of page views, QPS use, and site evaluations. Independent variables were sociodemographic background, disease status, psychological functioning, and information needs. All 101 counselees who were provided with a login accessed the website and spent, on average, 21 min viewing the website. Counselees affected with breast cancer spent more time on the website than unaffected counselees. Half of all page views were within the sequence of topics in the menu and older counselees, and those who made less use of the internet more often navigated according to the menu sequence than others. Having viewed information about why it is important to ask questions increased QPS use. Counselees who had higher information needs considered the information more helpful. This hospital-provided website for breast cancer genetic counselees was accessible and was evaluated positively, even concerning older counselees and those who had not searched the internet for information about hereditary cancer. Counselees might navigate hospital-provided websites more in line with the sequence of topics in the menu bar, than generally accessible health websites.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500, BN, Utrecht, The Netherlands. a.albada@nivel.nl
authors.forename: Akke
authors.initials: A
authors.lastname: Albada
authors.forename: Margreet G E M
authors.initials: MG
authors.lastname: Ausems
authors.forename: Roel
authors.initials: R
authors.lastname: Otten
authors.forename: Jozien M
authors.initials: JM
authors.lastname: Bensing
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology*; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008875:Middle Aged; D010353:Patient Education as Topic; D055815:Young Adult