Cancer Control Research
5R01CA084770-03
Green, Michael J.
COMPUTER EDUCATION FOR BREAST CANCER GENETIC TESTING
AbstractThe long term goal of this project is to improve patient understanding about breast cancer risk and genetic testing. We have previously developed a patient-oriented CD-ROM called "Counseling by Computer: Breast Cancer Risk and Genetic Testing ." The proposed research is to conduct a clinical trial to evaluate the effectiveness of the CD-ROM at educating women about breast cancer risk, and options and implications of genetic testing. This project will take 36 months to complete and involves two specific aims: Specific Aim 1: to evaluate the effectiveness of our CD-ROM at educating women about breast cancer risk, and the options and implications of genetic testing. We will complete this aim in two phases. During phase 1 we will obtain critical feedback on the CD-ROM and survey instruments from a diverse group of women in Central Pennsylvania. Forty women (at least 1/4 of whom are minorities) will be recruited from a general internal medicine clinic and breast cancer support group to evaluate the useability and effectiveness of the CD-ROM. The survey data will be used to refine the CD-ROM and study instruments in preparation for a randomized trial. Phase 2 will be to evaluate the impact of the CD-ROM on those actually considering genetic testing for breast cancer susceptibility, through a randomized, pretest-posttest control-group, crossover trial of 210 patients at three study sites. The effectiveness of computer-based education will be compared with one-on-one education for the impact on patients': risk perception; intent to receive genetic testing; knowledge about breast cancer risk and genetic testing; satisfaction with their decision about genetic testing; and decisional conflict. An assessment of the acceptability of each educational intervention will also be obtained. Specific Aim 2: to evaluate the impact of a prior computer-based educational session on subsequent interactions between patients and genetic counselors. As part of the randomized trial, we will study whether the addition of a computer-based educational program improves the interactions between patients and genetic counselors. Comparisons will be made between those educated by a genetic counselor alone, and those educated by a computer prior to their session with a genetic counselor, by measuring: the amount of time spent with a genetic counselor; the quality and quantity of questions directed to the genetic counselor; patient's and genetic counselor's satisfaction; and perceived effectiveness of the counseling session.
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