Informal caregivers need information, skills and emotional support to address physical, spiritual, and emotional needs associated with chronic illnesses including late stage cancer. Unfortunately, current conditions force clinicians to reduce interaction time with patients and informal caregivers. Complimentary methods must be developed to provide needed information and support to caregivers. The proposed research will measure and explain the impact of two computer-based support systems that meet caregiver needs and facilitate information exchange with clinicians. The system, CHESS (Comprehensive Health Enhancement Support System), is a non- commercial computer system that provides patients with disease specific information, emotional support and skills building tools. In the expanded form to be tested here, CHESS with Caregiver Support (CGCHESS) will also provide the caregiver with more information, support and skills training related to palliative care. CGCHESS will be further enhanced to communicate essential patient and caregiver information to clinicians prior to a scheduled clinic visit and when patient symptoms exceed a threshold. Using as recruitment sites the University of Wisconsin Comprehensive Cancer Centers in Madison and Milwaukee, 300 caregivers (33% minorities) of advanced breast and prostate cancer patients will be randomly assigned to: 1) Control group given usual care, 2) Caregiver CHESS (CGCHESS) designed to support both patients and caregivers and 3) Caregiver CHESS with Clinician Report (CGCHESS+CR). Inclusion of breast and prostate cancer patients will provide caregivers of both genders. Our primary hypothesis is that CGCHESS will significantly improve caregiver burden, affect, coping self-efficacy and information competence because of the information, skills building and emotional support CHESS offers to caregivers. We also hypothesize that CGCHESS+CR will improve the outcomes more and that minority caregivers will benefit more than Caucasians. Our process analyses will study the mechanisms of CHESS effect.
