Breast cancer is the most common cancer among women, with over one million new cases reported in the world each year. A diagnosis of breast cancer is frequently and understandably associated with high levels of psychosocial distress. While support groups and stress-management interventions have increased social support, reduced psychosocial and physiological stress, improved active coping, and enhanced psychosocial adjustment, less than 10 percent of patients attend these group-based interventions. This is particularly true of minority and other underserved women. In a Phase I project we developed an innovative interactive multimedia instructional CD-ROM entitled, Living With Breast Cancer. This product is unique in that it describes and normalizes the range of emotional reactions women with breast cancer experience, organizes and walks women through the medical landscape of breast cancer, directs women's education queries to appropriate sources when they need them, and offers skill building strategies for alleviating psychosocial stress and for creating and maintaining constructive social support. The goals of this Phase II project are to enhance and further refine our product and to develop a companion web site. The web site will provide updated information, links to additional valuable, carefully screened references and an opportunity for CD-ROM users to share their experiences with one another. We will recruit a sample of 120 women with breast cancer, across two demographically different sites, to participate in a randomized controlled trial of the effects of the product and the web site. Women will be randomly assigned to Enhanced Usual Care group (UC) who will receive an educational breast cancer video, or to the CD-ROM Intervention group (CDR) who will receive the Living With Breast Cancer product in addition to the video. Women will be assessed at baseline and 3-, 6-, 9-, and 12-month follow-up on psychosocial stress (i.e., life events, perceived stress), psychosocial distress (i.e., depression, trauma symptoms), coping, social support; physiological stress response (i.e., cortisol), breast cancer disease outcomes (i.e., recurrence), and consumer satisfaction. The products will be marketed to cancer treatment centers, independent oncology health care providers, pharmaceutical manufacturers and health maintenance organizations.
