Cancer produces profound social, interpersonal, psychological and communication challenges. The severity, sudden onset, and complexity of these challenges tax traditional health systems. The newly diagnosed cancer patient needs: clear and timely information, help in making decisions, emotional support, and effective coping skills. Modem communication technologies have the potential to provide interventions that target these distinct goals: the provision of information, social support or new/improved skills. Unfortunately, there is virtually no research establishing the relative worth of these goals, how well the different types of interventions accomplish their goals, and how the interventions work overall and for specific patient types. CHESS is an innovative technology that provides information, social support and skills training. Previous randomized trials of CHESS found improved patient welfare including quality of life (QOL), participation in decisions and health services use. But, as with other communication technologies, little is known about which strategies produce those benefits. Do patients do better with a broad array of expensive services, or will benefit result from fewer, less costly services? Answers will reveal factors that make communication technologies effective and how to enhance them. This controlled trial will examine whether breast cancer patient outcomes change as different types of conceptually distinct CHESS services (information, social support, and skills training) are systematically added to a patient's treatment resources. Process analyses will identify specific CHESS effects responsible for global outcomes such as improved QOL. CHESS is an ideal platform for investigating which communication treatments are effective given substantial evidence that something in CHESS is effective - we just do not know what it is, or how it works. Newly-diagnosed breast cancer patients (N = 360) will be randomly assigned to four intervention groups: a) CHESS providing information, social support and skills training (full CHESS), b) CHESS social support and information, c) CHESS information only, or d) a control group receiving usual care+interact access. Subjects will be tracked for 56 weeks to assess health, adjustment, and relational outcomes. This research will help reveal the types of treatments that are most helpful to cancer patients and how they work.
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