Trial Information

Facilitating Web-Based Patient Decision Support: Decision About Medication to Lower Breast Cancer Risk

BACKGROUND:

- Breast cancer chemoprevention has been notably underutilized.

- Barriers to integrating breast cancer risk reducing measures include: lack of time, low
priority of risk reduction in comparison to treatment, the need to personalize risks
and benefits of chemoprevention, and the need for resources/information necessary for
women to make informed decisions.

- Access to quality decision support resources to facilitate making informed,
preference-sensitive decisions about chemoprevention may provide a mechanism to
overcome some of the current barriers to chemoprevention utilization.

OBJECTIVES:

- Develop and refine a web-based patient decision support module for high-risk women
making a decision about breast cancer chemoprevention.

- Conduct a randomized study of TACHD decision support versus standard care online
information support to evaluate the impact of the chemoprevention module of the TACHD
decision support intervention.

ELIGIBILITY:

- Women with no history of cancer other than cervical carcinoma in situ or non-melanoma
skin cancer

- High risk for breast cancer based on at least one of the following:

- Gail score > 1.67

- History of atypical hyperplasia (either ductal or lobular)

- History of lobular carcinoma in situ

- Documentation of a deleterious BRCA1 or BRCA2 mutation

- Considering a decision about chemoprevention with tamoxifen or raloxifene

- Access to an IBM-compatible or MacIntosh personal computer with broadband Internet
access

- Access to an email account

- Access to a telephone

- Aged 35 or older

- Able to communicate in English verbally and in writing

DESIGN:

- The project will be guided by the Cognitive-Social Health Information Processing
(CSHIP) model overall, and incorporate the Ottawa Decision Support. Framework (ODSF) in
one consistent decision support process.

- Testing of the chemoprevention decision support module will be conducted in a two-group
pre- post-test experimental design with 64 at-risk women identified through Fox Chase
Risk Assessment Programs and the NCI Clinical Cancer Genetics Program (CCGP) at the
National Naval Medical Center (NNMC).

- A process evaluation analysis will assess participants' experiences using TACHD.