Prostate cancer patients and their families face the problems typical of all cancers as well as some that make their situation unique. Besides how the disease and its treatments affect quality of life (QOL) for patients and their partners, the open-ended uncertainty can further degrade QOL. Reducing that degradation and speeding the process of regaining control requires multiple complimentary resources: information about treatment options and side effects, skills for dealing with information and clinical systems, access to experiences and support of others in similar situations, and help dealing with the disease as a couple instead of as an individual. A web-based system of information, support and tools to aid prostate cancer patients known as CHESS (the Comprehensive Health Enhancement Support System) has been created. In addition, a human Cancer Information Mentor (based on the CIS Information Specialist role) may enhance the efficacy of CHESS by providing a continuing information-supportive relationship with a patient.
Newly-diagnosed patients will be randomly assigned to one of three conditions, all containing Internet access and lasting 6 months: 1) access to a human Cancer Information Mentor, 2) access to the full CHESS system and 3) CHESS and Mentor combined. We will test the relative efficacy of CHESS and a human Cancer Information Mentor against each other, and test the benefits of the two combined against the benefits of either alone. A total of 327 prostate cancer patients will be enrolled in this multi-site study: 105 will be recruited from University of Wisconsin Comprehensive Cancer Center (UWCCC), with 84 participants completing the study (20% drop out rate); 95 will be recruited from Hartford Hospital with 76 completing study; and 127 will be recruited from M.D. Anderson with 102 completing study. Participants will complete questionnaires prior to the intervention (baseline), 2, 6, 12, and 24 weeks post-baseline. Further, partners who wish to use CHESS and who provide their consent will also be enrolled. The aims include:
1) To measure the effect of the three study conditions on QOL.
· CHESS and Cancer Information Mentor will not differ initially (6 weeks) or late in treatment (6 months) in QOL
· CHESS +Cancer Information Mentor will have the largest impact on QOL (initially and late in treatment) and will be significantly better than either CHESS or Cancer Information Mentor alone.
2) To measure potential intervening or mediating processes, so that we can determine how CHESS and the Cancer Information Mentor produce associated QOL benefits.
3) To conduct exploratory use analyses examining which types of CHESS content, sequential patterns of content use, or other characteristics of use behavior are associated with greater pretest-posttest improvements in QOL.
4) To conduct a secondary analysis exploring whether men whose partners have actively used CHESS do better than those whose partners did not use CHESS. |