This proposal is a response to RFA #CA/HD-93-33, """"""""Rehabilitation and Psychosocial Research in Younger Women with Breast Cancer."""""""" The objectives of this research are: 1) to test the benefits of a computer-based support system (CHESS, the Comprehensive Health Enhancement Support System) on the quality of life and disability of younger women with breast cancer; and, 2) to begin to understand how and for what kind of people CHESS has that effect. CHESS uses expert systems, computer-mediated communication, data bases, and an easy-to-use interface to provide information, decision analysis, and social support services to women with breast cancer. Three hundred women with breast cancer under age 50 (including 100 minority women) will be recruited from hospitals in Madison and Chicago and will be randomized into control and experimental groups. Subjects will include women with breast cancer at Stages I to IV, including recurrent breast cancer. A CHESS computer will be placed into the homes of the experimental group members for six months, while the control group will have access to standard medical practice for patient education and support, supplemented by a consistent set of written information on breast cancer. Both groups will be surveyed at pre-test, and with 2, 4 and 8 month post-tests. The primary aim of this research is to understand the effect of CHESS on quality of -life for women with breast cancer. Specifically, we will examine whether access to CHESS produces more rapid and greater improvements in specific quality of life dimensions: functional, emotional, social-family, physical, and disease-specific complaints. We will also investigate impact of global quality of life as an exploratory analysis. The secondary aim is to begin to explore: l) whether CHESS has an effect on detailed functional performance and level of disability; and, 2) how and for what kinds of patients (e.g., minorities, more or less educated, stage of disease, etc.) does CHESS have its effects on quality of life.
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