Journal of General Internal Medicine

, Volume 16, Issue 7, pp 435–445 | Cite as

Effect of computer support on younger women with breast cancer

  • David H. GustafsonEmail author
  • Robert Hawkins
  • Suzanne Pingree
  • Fiona McTavish
  • Neeraj K. Arora
  • John Mendenhall
  • David F. Cella
  • Ronald C. Serlin
  • Funmi M. Apantaku
  • James Stewart
  • Andrew Salner
Original Articles


OBJECTIVE: Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved.

DESIGN: Randomized controlled trial conducted between 1995 and 1998.

SETTING: Five sites: two teaching hospitals (Madison, Wis, and Chicago, Ill), two nonteaching hospitals (Chicago, Ill), and a cancer resource center (Indianapolis, Ind). The latter three sites treat many underserved patients.

PARTICIPANTS: Newly diagnosed breast cancer patients (N=246) under age 60.

INTERVENTIONS: Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support.

MEASUREMENTS AND MAIN RESULTS: Pretest and two posttest surveys (at two- and five-month follow-up) measured aspects of participation in care, social/information support, and quality of life. At two-month follow-up, the CHESS group was significantly more competent at seeking information, more comfortable participating in care, and had greater confidence in doctor(s). At five-month follow-up, the CHESS group had significantly better social support and also greater information competence. In addition, experimental assignment interacted with several indicators of medical underservice (race, education, and lack of insurance), such that CHESS benefits were greater for the disadvantaged than the advantaged group.

CONCLUSIONS: Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.

Key Words

breast cancer quality of life patient participation computer patient education disadvantaged Digital Divide 


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Copyright information

© Blackwell Science Inc 2001

Authors and Affiliations

  • David H. Gustafson
    • 1
    Email author
  • Robert Hawkins
    • 2
  • Suzanne Pingree
    • 3
  • Fiona McTavish
    • 4
  • Neeraj K. Arora
    • 9
  • John Mendenhall
    • 10
  • David F. Cella
    • 7
    • 11
  • Ronald C. Serlin
    • 5
  • Funmi M. Apantaku
    • 12
  • James Stewart
    • 6
  • Andrew Salner
    • 8
    • 13
  1. 1.Received from the Departments of Industrial Engineering and Preventive Medicinethe University of Wisconsin-MadisonMadison
  2. 2.the School of Journalism and Mass Communicationthe University of Wisconsin-MadisonMadison
  3. 3.the Department of Life Sciences Communicationthe University of Wisconsin-MadisonMadison
  4. 4.the Center for Health Systems Research and Analysisthe University of Wisconsin-MadisonMadison
  5. 5.the Department of Educational Psychologythe University of Wisconsin-MadisonMadison
  6. 6.the Department of Clinical Oncologythe University of Wisconsin-MadisonMadison
  7. 7.the Department of Psychiatry and Behavioral Sciencethe University of Wisconsin-MadisonMadison
  8. 8.the Department of Radiation Oncology and The Cancer Programthe University of Wisconsin-MadisonMadison
  9. 9.Division of Cancer Control and Population SciencesNational Cancer InstituteBethesda
  10. 10.SBC Technology Resources, Inc.Austin
  11. 11.Evanston Northwestern HealthcareEvanston
  12. 12.National Black Leadership Initiative on CancerUniversity of Illinois at ChicagoChicago
  13. 13.Hartford HospitalHartford

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