title: Feasibility of Providing Web-Based Information to Breast Cancer Patients Prior to a Surgical Consult.
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.
authors.affiliation: School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors.forename: Jordan G
authors.initials: JG
authors.lastname: Bruce
authors.affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Tucholka
authors.affiliation: Denver Public Health, Denver Health and Hospital Authority, Denver, CO, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Steffens
authors.affiliation: Department of Medicine, Section of Geriatrics, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Mahoney
authors.affiliation: School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. neuman@surgery.wisc.edu.|Wisconsin Surgical Outcomes Research Program, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. neuman@surgery.wisc.edu.|Carbone Cancer Center, University of Wisconsin, Madison, WI, USA. neuman@surgery.wisc.edu.|, H4/726 CSC, 600 Highland Ave, Madison, WI, 53792, USA. neuman@surgery.wisc.edu.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Neuman
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003657:Decision Making; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010353:Patient Education as Topic; D012017:Referral and Consultation
keywords: Breast cancer surgery; Decision support; Implementation; Internet; Web-based information