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Counselees’ use and evaluation of a website providing computer-tailored information and a question prompt prior to breast cancer genetic counseling by Akke Albada, Sandra van Dulmen, Margreet Ausems and Jozien Bensing
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Counselees’ use and evaluation of a website providing computer-tailored information and a question prompt prior to breast cancer genetic counseling by Akke Albada, Sandra van Dulmen, Margreet Ausems and Jozien Bensing

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  • 1.
    • Counselees’ use and evaluation of a website providing computer-tailored information and a question prompt prior to breast cancer genetic counseling
    • Akke Albada, Sandra van Dulmen, Margreet Ausems, Jozien Bensing
  • 2. Intervention objectives
    • Increase in:
    • 1 Realistic expectations of breast cancer genetic counseling
    • Counselee knowledge
    • 2 Counselee participation within the consultation
    • Website prompts counselees to prepare questions
  • 3. Intervention:
    • Website for counselees to access prior to their first visit:
    • tailored information
    • question prompt (Invitation to write down 5 questions)
  • 4. E-info gene ca
    • Website for counselees
    • (password access)
    • With information about:
      • Procedure of genetic counselling
      • criteria for DNA testing
      • bc population risks
      • screening options
      • Emotional consequences
      • Communication with family members
      • How to participate in the consultation
  • 5.  
  • 6.  
  • 7. Respondent characteristics (N=90) 89.9 Information preference (extensive) 50.6 Probability of indication for DNA-test (high) - - - - - - 8.9 51.6 39.3 Education: < High school level High school/ vocational courses University (MSc/BSc)/ higher vocational education (BSc) 73 Children (having children) - - 49.4 Personal history of breast cancer (affected) 42.8 (11.4) 21-70 - Age Mean (SD) Range %
  • 8. Counselees’ ratings of E-info gene ca (N=75) 12.2 9 Too much 10.9 8 Confusing 17.6 13 Upsetting 70.3 52 Reassuring 78.7 59 Personally relevant 89.3 67 Helpful to family and friends 94.6 70 Timely 96.0 72 Helpful 98.7 74 Reliable 98.7 74 Easy to understand 100 76 Useful The information on the website was … 94.4 68 Nicely designed 100 75 Neatly arranged 100 74 Clearly structured % n The website was … (totally) agree
  • 9. Log file data
    • Web page requests by date and time with respondent id
    • Advantage: dosage of intervention as process measure
    • Content analysis on QPS
    QPS
  • 10. Results
    • Mean visited pages 11 of all 19 web pages (SD 8)
    • Each page was viewed 2.2 times on average
    • Mean of 10:22 minutes spend on the website (SD 8:40 min.)
    Number of page views Duration of site visit
  • 11. Results: most viewed topics
    • Expectations of genetic counselling (97%)
    • DNA-testing (97%)
    • Screening (94%)
    • Hereditary breast cancer (90%)
    • Emotional consequences (87%)
    • Procedure of genetic counselling (45%)
    • Analysis of family history (36%)
  • 12. Results: Sequence of page views
    • The sequence of items in the menu bar influenced sequence of page views
    • On average 48% (SD 30%) of the page requests were in accordance with the provided random menu sequence.
    • 6.9 of the 19.7 page views
  • 13. Factors influencing total duration of website visit
    • Bivariate:
    • Affected counselees spent more time
    • (11:35 vs. 8:03 min for unaffected counselees (t=3.25 α =.02))
    • Anxious counselees spent more time
    • (r=.27 α =.01)
    • Multivariate
    • Anxiety B=.45 α =.002
    • Controlling for age, education, knowledge, info needs, worry, having children and being affected
  • 14. Questions posed
    • 42.2% of counselees posed questions
    • On average 3.2 questions
    • (SD 1.2)
  • 15. Content of questions
    • DNA-testing (18)
    • Screening options for self or children (16)
    • My risk for breast cancer (15)
    • Family members’ risk (14)
    • Indications for hereditary breast cancer (14)
    • Inheritance (9)
  • 16. Examples of questions
    • “ Can a DNA test result tell whether I will have breast cancer again?”
    • “ My daughter just started taking birth control pils, does that increase her risk?”
    • “ What is the chance that I have this hereditary gene?”
    • “ Should I have regular breast screening?”
    • “ If it is hereditary till which generation will it last?”
  • 17. Site visit not predictive for questions on QPS
    • Counselees using QPS did not spend more time on the site than others
    • No significant correlation between number of questions and duration of site view
    • No relation between question content and topics of viewed pages
  • 18.
      • Recap
      • E-info gene ca = website for breast cancer genetic counselees to better prepare for their first visit
      • Counselees visited most pages
      • In the provided sequence
      • Posed questions unrelated to page views
  • 19.
    • [email_address]
    Questions and discussion Funded by Dutch Cancer Society