Effectiveness of the Chess E-Health Cancer Support Intervention in Population-Bas

项目摘要 交互式癌症交流系统(ICCS)具有为癌症患者提供 以具有成本效益的方式提供关于其疾病和治疗的准确信息。虽然数据表明 ICCS可能使癌症患者受益，但重要的知识差距仍然存在：差距应该在 ICCS被更广泛地纳入医疗保健。需要关于ICCS对以下结果的影响的数据 患者的情绪幸福感，临床医生对临床接触的反应，以及医疗保健利用和 成本效益。此外，几乎所有关于ICCS的数据都来自疗效试验。人们对此知之甚少 许多ICCS将被使用，它们的影响将是什么，以及如何在现实世界的医疗保健环境中促进它们的使用。 该提案描述了一项将在凯撒永久西北地区(KPNW)内进行的研究 医疗保健系统。乳腺癌患者将被告知可获得KPNW乳腺癌 信息网站。访问该网站的患者数量将反映出对KPNW互联网乳房的兴趣 KPNW人群中的癌症来源和ICCS的潜在覆盖范围。进入网站后， 女性(N=600)将有机会参加一个2×2的随机试验，在这个试验中，她们可以在网上做志愿者 随机分为两组：(1)提供有关KPNW资源的静态信息的基本ICCS 关于乳腺癌的文章，或(2)包含相同静态资源的增强型ICCS条件 CHESS(一种在疗效试验中使乳腺癌患者受益的ICCS)。国际象棋的供应将是 与一些女性通过信件和电话提示使用ICCS的提示条件相交叉 来自KPNW，而其他人不会。结果衡量标准将包括ICCS使用量和妇女对 癌症信息能力、感受到的社会支持和情绪健康，其他结果将 包括医疗保健利用率、成本效益和临床医生对医疗保健就诊的评级。建议数 研究应提供有关全面ICCS的商业和临床病例的信息 真实世界用于癌症护理的背景。这项中心拨款集中在国际象棋上，这是一种计算机程序 旨在为患有乳腺癌的女性提供支持和信息。这项“有效性”研究将显示 国际象棋如何在现实世界的医疗保健环境中发挥作用，产生了关于女性使用国际象棋的新数据，无论是 国际象棋帮助女性感觉更了解情况，减少焦虑，以及它是否降低了医疗成本。

Project Summary Interactive cancer communication systems (ICCS) have great potential to provide cancer patients with accurate information on their diseases and treatments in a cost-effective manner. While data suggest that ICCS may benefit cancer patients, important knowledge gaps remain: gaps that should be addressed before ICCS are more broadly incorporated into healthcare. Data are needed on ICCS effects on such outcomes as patients' emotional well being, on clinicians' reactions to clinical encounters, and on healthcare utilization and cost-effectiveness. In addition, almost all data on ICCS come from efficacy trials. Little is known about how much ICCS will be used, what their effects will be, and how to foster their use in real world healthcare contexts. This proposal describes a study that will be conducted within the Kaiser Permanente Northwest (KPNW) healthcare system. Breast cancer patients will be informed of the availability of a KPNW Breast Cancer Information website. The number of patients visiting that site will reflect interest in KPNW internet breast cancer resources and potential reach of an ICCS within the KPNW population. After entering the website, women (N=600) will be offered the opportunity to join a 2 X 2 randomized trial in which they can volunteer online to be randomized to either: (1.) a Basic ICCS that provides static information on KPNW resources and articles on breast cancer, or (2) an Enhanced ICCS condition that comprises those same static resources + CHESS (an ICCS that has benefited breast cancer patients in efficacy trials). CHESS availability will be crossed with a Prompt condition in which some women will have ICCS use prompted by letters and phone calls from KPNW while others will not. Outcome measures will include amount of ICCS use and women's ratings of cancer information competence, perceived social support, and emotional well being, Other outcomes will include healthcare utilization, cost-effectiveness, and clinician ratings of healthcare visits. The proposed research should provide information about the business and clinical cases for a comprehensive ICCS in the context of real world use for cancer care. This center grant focuses on CHESS, a computer program that is designed to give support and information to women with breast cancer. This "Effectiveness" study will show how CHESS works in real world healthcare setting, yielding new data on women's use of CHESS, whether CHESS helps women feel better informed and less anxious, and whether it reduces healthcare costs.