The overall goal of this application is: 1) to develop and testa highly innovative virtual CIS (V-CIS) multimedia preparatory and educational intervention (CD-ROM and web-based) to facilitate patient education, informed treatment decision-making and adjustment; 2) to develop and test a telephone callback protocol conducted by the NCI's Cancer Information Service (CIS) Information Specialists; and 3) to evaluate the interventions in two complimentary randomized designs. For those with computer access, a three-group, stepped design will be used as follows: Group 1 control group = standard CIS service (+) print material; Group 2 = Group 1 + V-CIS software; and Group 3 = Group 2+2 CIS telephone callbacks. For those lacking computer access, a randomized two-group design will be used: Group 1A = control = same as Group 1; Group 2A = Group 1A + 2 CIS intervention callbacks. To test the efficacy of the interventions, 1800 callers to the CIS will be enrolled, and depending on computer access, randomized to either the 3- group or the 2-group design, and contacted at 2, 6, and 12 months. Conforming to a dose-response gradient, the primary hypothesis is that Group 3 > Group 2 > Group 1, and Group 2A > Group 1A ,with regard to psychological health (i.e., adjustment), decisional conflict, and quality of life. Mediational and moderator hypotheses will also be examined. Project 1 is unique as it combines a state-of-the-science software program with proactive CIS-initiated telephone callbacks. Contingent upon findings, the goal of the CISRC is to prepare the interventions for dissemination within the CIS and other service programs nationwide.
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