In randomized clinical trials, interactive cancer communication systems (ICCS) have shown benefits to patient quality of life, social support, and competence dealing with health information and the healthcare system. But we as yet know little about how much they would be promoted by healthcare organizations and used by patients in real-world, non-research settings. This implementation trial will make CHESS (a well-tested ICCS) available to all breast cancer patients at two differently-structured Denver healthcare systems: Kaiser- Permanente Colorado and Exempla St. Joseph Hospital, and will compare the demographic and disease characteristics of those who do or do not use CHESS. Three months after diagnosis, one subsample of patients will answer a brief survey about their breast cancer experience, quality of life, and information/support resources used, and another subsample will participate in detailed qualitative interviews about their experiences with resources to support breast cancer patients. Clinicians will report their satisfaction with visits by members of the two patient samples, and we will also report a detailed descriptive analysis of implementation procedures and clinician perceptions of CHESS. This research will demonstrates to what degree a previously-successful ICCS is utilized as standard care in real-world conditions, will pursue a variety of 'why'questions about what produces or inhibits such use, and will examine how that use is related to patient and staff perceptions. The data from this study will be relevant to decisions about whether and how to disseminate ICCS, especially in healthcare systems where the intervention might be integrated with other aspects of patient care. Both participating organizations have committed to continue providing CHESS to their patients after the grant period ends.
Patients facing disease turn to online sources almost as frequently as to medical professionals, but the varied quality of Internet resources has proved to be less beneficial than integrated systems of reliable information and supportive tools. This project proposes to take a well-tested integrated system out of the research setting, and test it in two real-world healthcare organizations by making it available to all breast cancer patients. Observing the extent to which the organizations promote it and how much it is used (and by whom) will inform and improve future adoption decisions of such technology.