Abstract
While many women turn to the Internet to obtain health information, it is unlikely that unstructured Internet use provides optimal benefit to women newly diagnosed with breast cancer, due to uneven quality, conflicting claims, redundancy, and search engine idiosyncrasies, which may make finding information and assessing its accuracy and applicability difficult. To answer the need for information and support, the Comprehensive Health Enhancement Support System (CHESS) was developed to provide access to integrated information for decision-making, behavior change, and emotional support, and has been validated in randomized trials. This observational study of real-world implementation focuses on the process of integrating CHESS into standard care in two Denver healthcare systems. Results from this study provide guidance for implementation of other web-based patient information and support programs in large healthcare organizations.
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Acknowledgments
This was an investigator-initiated study funded through National Institute of Health (NIH) grant no. 1R01CA149005-01A1. The NIH played no role in the design, conduct, or analysis of the study and interpretation of findings. All authors had full access to data and take responsibility for the integrity of the data and accuracy of the analysis.
Conflict of interest
The authors Alanna Kulchak Rahm, Robert P. Hawkins, James W. Dearing, Suzanne Pingree, Jana Bolduan Lomax, Helen McDowell, Erica Ferro Morse, and BreAnne Barela declare that they have no conflict of interest; no financial relationships with any organizations that might have an interest in the submitted work; and no other relationships or activities that could appear to have influenced the submitted work. The authors also state that they have full control of all primary data, and that they agree to allow the journal to review their data if requested.
Adherence to ethical principles
This study was reviewed and approved by the Institutional Review Boards (IRB) at the University of Wisconsin Madison, Exempla Saint Joseph Health System, and Kaiser Permanente Colorado.
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Implications
Policy: Organizational priorities and changes affect implementation, and the innovation will not be considered a factor in any changes being made if constant communication is not maintained with leadership as well as end-users.
Research: Research on implementation of programs within health systems provides much needed insights into the reasons why certain implementation strategies may or may not work in different settings.
Practice: Creating processes for constant formal and informal communication and objective tracking of events affecting implementation can help with the process of implementation and dissemination of interventions throughout any organization.
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Rahm, A.K., Hawkins, R.P., Dearing, J.W. et al. Implementing an evidence-based breast cancer support and communication tool to newly diagnosed patients as standard care in two institutions. Behav. Med. Pract. Policy Res. 5, 198–206 (2015). https://doi.org/10.1007/s13142-015-0305-4
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DOI: https://doi.org/10.1007/s13142-015-0305-4