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Published in: Translational Behavioral Medicine 1/2011

01-03-2011

Effects of a Web-based intervention on women’s breast health behaviors

Authors: Deborah J Bowen, PhD, Robert Robbins, PhD, Nigel Bush, PhD, Hendrika Meischke, PhD, Abi Ludwig, Jean Wooldridge, MPH

Published in: Translational Behavioral Medicine | Issue 1/2011

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Abstract

Helping women make choices to reduce cancer risk and to improve breast health behaviors is important, but the best ways to reach more people with intervention assistance is not known. To test the efficacy of a Web-based intervention designed to help women make better breast health choices, we adapted our previously tested, successful breast health intervention package to be delivered on the Internet, and then we tested it in a randomized trial. We recruited women from the general public to be randomized to either an active intervention group or a delayed intervention control group. The intervention consisted of a specialized Web site providing tailored and personalized risk information to all participants, followed by offers of additional support if needed. Follow-up at 1-year post-randomization revealed significant improvements in mammography screening in intervention women compared with control women (improvement of 13 percentage points). The intervention effects were more powerful in women who increased breast health knowledge and decreased cancer worry during intervention. These data indicate that increases in mammography can be accomplished in population-based mostly insured samples by implementing this simple, low resource intensive intervention.
Literature
1.
go back to reference Bowen, D., et al. (2002). Results of an adjunct dietary intervention program in the Women’s Health Initiative. Journal of the American Dietetic Association, 102(11), 1631–1637.PubMedCrossRef Bowen, D., et al. (2002). Results of an adjunct dietary intervention program in the Women’s Health Initiative. Journal of the American Dietetic Association, 102(11), 1631–1637.PubMedCrossRef
2.
go back to reference Bowen, D., et al. (1999). Participation in breast cancer risk counseling among women with a family history. Cancer Epidemiology, Biomarkers & Prevention, 8(7), 581–585. Bowen, D., et al. (1999). Participation in breast cancer risk counseling among women with a family history. Cancer Epidemiology, Biomarkers & Prevention, 8(7), 581–585.
3.
go back to reference Bowen, D. J., & Beresford, S. A. (2002). Dietary interventions to prevent disease. Annual Review of Public Health, 23, 255–286.PubMedCrossRef Bowen, D. J., & Beresford, S. A. (2002). Dietary interventions to prevent disease. Annual Review of Public Health, 23, 255–286.PubMedCrossRef
4.
go back to reference Bowen, D. J., et al. (2002). Effects of risk counseling on interest in breast cancer genetic testing for lower risk women. Genetics in Medicine, 4(5), 359–365.PubMedCrossRef Bowen, D. J., et al. (2002). Effects of risk counseling on interest in breast cancer genetic testing for lower risk women. Genetics in Medicine, 4(5), 359–365.PubMedCrossRef
5.
go back to reference Bowen, D. J., et al. (1998). Effects of counseling and ethnic identity on perceived risk and cancer worry in African American women. Journal of Clinical Psychology in Medical Settings, 05(3), 365–379.CrossRef Bowen, D. J., et al. (1998). Effects of counseling and ethnic identity on perceived risk and cancer worry in African American women. Journal of Clinical Psychology in Medical Settings, 05(3), 365–379.CrossRef
6.
go back to reference Bowen, D. J., et al. (2003). Predicting breast cancer screening intentions and behavior with emotion and cognition. Journal of Social and Clinical Psychology, 22(2), 212–232.CrossRef Bowen, D. J., et al. (2003). Predicting breast cancer screening intentions and behavior with emotion and cognition. Journal of Social and Clinical Psychology, 22(2), 212–232.CrossRef
7.
go back to reference Bowen, D. J., et al. (2003). Early experience with a web-based intervention to inform risk of breast cancer. Journal of Health Psychology, 8(1), 175–186.CrossRef Bowen, D. J., et al. (2003). Early experience with a web-based intervention to inform risk of breast cancer. Journal of Health Psychology, 8(1), 175–186.CrossRef
8.
go back to reference Bowen, D. J., et al. (2003). Jewish identity and intentions to obtain breast cancer screening. Cultural Diversity and Ethnic Minority Psychology, 9(1), 79–87.PubMedCrossRef Bowen, D. J., et al. (2003). Jewish identity and intentions to obtain breast cancer screening. Cultural Diversity and Ethnic Minority Psychology, 9(1), 79–87.PubMedCrossRef
9.
go back to reference Esplen, M. J., et al. (2000). Supportive-expressive group intervention for women who test positive for BRCA 1/2. Psycho-Oncology, 9(5 Suppl), S1–S106. Esplen, M. J., et al. (2000). Supportive-expressive group intervention for women who test positive for BRCA 1/2. Psycho-Oncology, 9(5 Suppl), S1–S106.
10.
go back to reference Esplen, M. J., et al. (1998). A group therapy approach to facilitate integration of risk information for women at risk for breast cancer. Canadian Journal of Psychiatry, 43(4), 375–380. Esplen, M. J., et al. (1998). A group therapy approach to facilitate integration of risk information for women at risk for breast cancer. Canadian Journal of Psychiatry, 43(4), 375–380.
11.
go back to reference Esplen, M. J., et al. (2000). A supportive-expressive group intervention for women with a family history of breast cancer: results of a phase II study. Psycho-Oncology, 9(3), 243–252.PubMedCrossRef Esplen, M. J., et al. (2000). A supportive-expressive group intervention for women with a family history of breast cancer: results of a phase II study. Psycho-Oncology, 9(3), 243–252.PubMedCrossRef
12.
go back to reference Lerman, C., Audrain, J., & Croyle, R. T. (1994). DNA-testing for heritable breast cancer risks: lessons from traditional genetic counseling. Annals of Behavioral Medicine, 16(4), 327. Lerman, C., Audrain, J., & Croyle, R. T. (1994). DNA-testing for heritable breast cancer risks: lessons from traditional genetic counseling. Annals of Behavioral Medicine, 16(4), 327.
13.
go back to reference Lerman, C., et al. (1997). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal of the National Cancer Institute, 89(2), 148–157.PubMedCrossRef Lerman, C., et al. (1997). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal of the National Cancer Institute, 89(2), 148–157.PubMedCrossRef
14.
go back to reference Lerman, C., et al. (1999). Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Cancer Epidemiology, Biomarkers & Prevention, 8(4 Pt 2), 361–367. Lerman, C., et al. (1999). Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Cancer Epidemiology, Biomarkers & Prevention, 8(4 Pt 2), 361–367.
15.
go back to reference Lerman, C., Kash, K., & Stefanek, M. (1994). Younger women at increased risk for breast cancer: perceived risk, psychological well-being, and surveillance behavior. Journal of the National Cancer Institute. Monographs, 16, 171–176.PubMed Lerman, C., Kash, K., & Stefanek, M. (1994). Younger women at increased risk for breast cancer: perceived risk, psychological well-being, and surveillance behavior. Journal of the National Cancer Institute. Monographs, 16, 171–176.PubMed
16.
go back to reference Lerman, C., et al. (1995). Effects of individualized breast cancer risk counseling: a randomized trial. Journal of the National Cancer Institute, 87(4), 286–292.PubMedCrossRef Lerman, C., et al. (1995). Effects of individualized breast cancer risk counseling: a randomized trial. Journal of the National Cancer Institute, 87(4), 286–292.PubMedCrossRef
17.
go back to reference Lerman, C., et al. (1996). A randomized trial of breast cancer risk counseling: interacting effects of counseling, educational level, and coping style. Health Psychology, 15(2), 75–83.PubMedCrossRef Lerman, C., et al. (1996). A randomized trial of breast cancer risk counseling: interacting effects of counseling, educational level, and coping style. Health Psychology, 15(2), 75–83.PubMedCrossRef
18.
go back to reference Taplin, S., Anderman, C., & Grothaus, L. (1989). Breast cancer risk and participation in mammographic screening. American Journal of Public Health, 79(11), 1494–1498.PubMedCrossRef Taplin, S., Anderman, C., & Grothaus, L. (1989). Breast cancer risk and participation in mammographic screening. American Journal of Public Health, 79(11), 1494–1498.PubMedCrossRef
19.
go back to reference Taplin, S. H., et al. (2000). Testing reminder and motivational telephone calls to increase screening mammography: a randomized study. Journal of the National Cancer Institute, 92(3), 233–242.PubMedCrossRef Taplin, S. H., et al. (2000). Testing reminder and motivational telephone calls to increase screening mammography: a randomized study. Journal of the National Cancer Institute, 92(3), 233–242.PubMedCrossRef
20.
go back to reference Kendall, C., & Hailey, B. J. (1993). The relative effectiveness of three reminder letters on making and keeping mammogram appointments. Behavioral Medicine, 19(1), 29–34.PubMedCrossRef Kendall, C., & Hailey, B. J. (1993). The relative effectiveness of three reminder letters on making and keeping mammogram appointments. Behavioral Medicine, 19(1), 29–34.PubMedCrossRef
21.
go back to reference Lerman, C., & Schwartz, M. (1993). Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Research and Treatment, 28(2), 145–155.PubMedCrossRef Lerman, C., & Schwartz, M. (1993). Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Research and Treatment, 28(2), 145–155.PubMedCrossRef
22.
go back to reference Bowen, D. J., et al. (2010) Effects of a public health intervention on women’s breast health behaviors. Health Education and Behavior Bowen, D. J., et al. (2010) Effects of a public health intervention on women’s breast health behaviors. Health Education and Behavior
23.
go back to reference Abrams, D. B., et al. (1996). Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: a combined stepped-care and matching model. Annals of Behavioral Medicine, 18(4), 290–304.PubMedCrossRef Abrams, D. B., et al. (1996). Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: a combined stepped-care and matching model. Annals of Behavioral Medicine, 18(4), 290–304.PubMedCrossRef
24.
go back to reference Bowen, D. J., et al. (2004). Breast cancer risk counseling improves women’s functioning. Patient Education and Counseling, 53(1), 79–86.PubMedCrossRef Bowen, D. J., et al. (2004). Breast cancer risk counseling improves women’s functioning. Patient Education and Counseling, 53(1), 79–86.PubMedCrossRef
25.
go back to reference Rabin, B. A., et al. (2010). Dissemination and implementation research on community-based cancer prevention: a systematic review. American Journal of Preventive Medicine, 38(4), 443–456.PubMedCrossRef Rabin, B. A., et al. (2010). Dissemination and implementation research on community-based cancer prevention: a systematic review. American Journal of Preventive Medicine, 38(4), 443–456.PubMedCrossRef
26.
go back to reference Marcus, B. H., et al. (1998). Physical activity interventions using mass media, print media, and information technology. American Journal of Preventive Medicine, 15(4), 362–378.PubMedCrossRef Marcus, B. H., et al. (1998). Physical activity interventions using mass media, print media, and information technology. American Journal of Preventive Medicine, 15(4), 362–378.PubMedCrossRef
27.
go back to reference Oenema, A., Brug, J., & Lechner, L. (2001). Web-based tailored nutrition education: results of a randomized controlled trial. Health Education Research, 16(6), 647–660.PubMedCrossRef Oenema, A., Brug, J., & Lechner, L. (2001). Web-based tailored nutrition education: results of a randomized controlled trial. Health Education Research, 16(6), 647–660.PubMedCrossRef
28.
go back to reference Cassell, M. M., Jackson, C., & Cheuvront, B. (1998). Health communication on the internet: an effective channel for health behavior change? Journal of Health Communication, 3(1), 71–79.PubMedCrossRef Cassell, M. M., Jackson, C., & Cheuvront, B. (1998). Health communication on the internet: an effective channel for health behavior change? Journal of Health Communication, 3(1), 71–79.PubMedCrossRef
29.
go back to reference Ferguson, T. (1995). Consumer health informatics. The Healthcare Forum journal, 38(1), 28–33.PubMed Ferguson, T. (1995). Consumer health informatics. The Healthcare Forum journal, 38(1), 28–33.PubMed
30.
go back to reference Green, M. J., & Fost, N. (1997). An interactive computer program for educating and counseling patients about genetic susceptibility to breast cancer. Journal of Cancer Education, 12(4), 204–208.PubMed Green, M. J., & Fost, N. (1997). An interactive computer program for educating and counseling patients about genetic susceptibility to breast cancer. Journal of Cancer Education, 12(4), 204–208.PubMed
31.
go back to reference Hoffman-Goetz, L., & Clarke, J. N. (2000). Quality of breast cancer sites on the World Wide Web. Canadian Journal of Public Health, 91(4), 281–284. Hoffman-Goetz, L., & Clarke, J. N. (2000). Quality of breast cancer sites on the World Wide Web. Canadian Journal of Public Health, 91(4), 281–284.
32.
go back to reference Wootton, J. C. (1997). The quality of information on women’s health on the Internet. Journal of Women’s Health/The Official Publication of the Society for the Advancement of Women’s Health Research, 6(5), 575–581.PubMed Wootton, J. C. (1997). The quality of information on women’s health on the Internet. Journal of Women’s Health/The Official Publication of the Society for the Advancement of Women’s Health Research, 6(5), 575–581.PubMed
33.
go back to reference Atienza, A. A., et al. (2010). E-health research and patient-centered care examining theory, methods, and application. American Journal of Preventive Medicine, 38(1), 85–88.PubMedCrossRef Atienza, A. A., et al. (2010). E-health research and patient-centered care examining theory, methods, and application. American Journal of Preventive Medicine, 38(1), 85–88.PubMedCrossRef
35.
go back to reference Leventhal, H. (1987). Behavioral theories and the problem of compliance. Patient Education and Counseling, 10, 117–136.CrossRef Leventhal, H. (1987). Behavioral theories and the problem of compliance. Patient Education and Counseling, 10, 117–136.CrossRef
36.
go back to reference Decruyenaere, M., et al. (2000). Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective. Psychooncology, 9(6), 528–536.PubMedCrossRef Decruyenaere, M., et al. (2000). Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective. Psychooncology, 9(6), 528–536.PubMedCrossRef
37.
go back to reference Hoskins, K. F., et al. (1995). Assessment and counseling for women with a family history of breast cancer. A guide for clinicians. Jama, 273(7), 577–585.PubMedCrossRef Hoskins, K. F., et al. (1995). Assessment and counseling for women with a family history of breast cancer. A guide for clinicians. Jama, 273(7), 577–585.PubMedCrossRef
38.
go back to reference Shattuck-Eidens, D., et al. (1995). A collaborative survey of 80 mutations in the BRCA1 breast and ovarian cancer susceptibility gene. Implications for presymptomatic testing and screening. Jama, 273(7), 535–541.PubMedCrossRef Shattuck-Eidens, D., et al. (1995). A collaborative survey of 80 mutations in the BRCA1 breast and ovarian cancer susceptibility gene. Implications for presymptomatic testing and screening. Jama, 273(7), 535–541.PubMedCrossRef
39.
go back to reference Gail, M. H., et al. (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Journal of the National Cancer Institute, 81(24), 1879–1886.PubMedCrossRef Gail, M. H., et al. (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Journal of the National Cancer Institute, 81(24), 1879–1886.PubMedCrossRef
40.
go back to reference Burke, W., et al. (2000). Genetic counseling for women with an intermediate family history of breast cancer. American Journal of Medical Genetics, 90(5), 361–368.PubMedCrossRef Burke, W., et al. (2000). Genetic counseling for women with an intermediate family history of breast cancer. American Journal of Medical Genetics, 90(5), 361–368.PubMedCrossRef
41.
go back to reference Biesecker, B. B., et al. (1993). Genetic counseling for families with inherited susceptibility to breast and ovarian cancer. Jama, 269(15), 1970–1974.PubMedCrossRef Biesecker, B. B., et al. (1993). Genetic counseling for families with inherited susceptibility to breast and ovarian cancer. Jama, 269(15), 1970–1974.PubMedCrossRef
42.
go back to reference Botkin, J. R., et al. (1996). A model protocol for evaluating the behavioral and psychosocial effects of BRCA1 testing. Journal of the National Cancer Institute, 88(13), 872–882.PubMedCrossRef Botkin, J. R., et al. (1996). A model protocol for evaluating the behavioral and psychosocial effects of BRCA1 testing. Journal of the National Cancer Institute, 88(13), 872–882.PubMedCrossRef
43.
go back to reference Andersen, M. R., & Urban, N. (1997). Physician gender and screening: Do patient differences account for differences in mammography use? Women & Health, 26(1), 29–39.CrossRef Andersen, M. R., & Urban, N. (1997). Physician gender and screening: Do patient differences account for differences in mammography use? Women & Health, 26(1), 29–39.CrossRef
44.
go back to reference Lerman, C., et al. (1991). Psychological side effects of breast cancer screening. Health Psychology, 10(4), 259–267.PubMedCrossRef Lerman, C., et al. (1991). Psychological side effects of breast cancer screening. Health Psychology, 10(4), 259–267.PubMedCrossRef
45.
go back to reference Hays, R. D., Sherbourne, C. D., & Mazel, R. M. (1993). The RAND 36-item health survey 1.0. Health Economics, 2(3), 217–227.PubMedCrossRef Hays, R. D., Sherbourne, C. D., & Mazel, R. M. (1993). The RAND 36-item health survey 1.0. Health Economics, 2(3), 217–227.PubMedCrossRef
46.
go back to reference Hannon, M., et al. (2011) Measuring perceptions of breast cancer risk. Health Psychology (Under review). Hannon, M., et al. (2011) Measuring perceptions of breast cancer risk. Health Psychology (Under review).
47.
go back to reference Weinstein, N. D. (1987). Taking care: understanding and encouraging self-protective behavior. New York: Cambridge University Press.CrossRef Weinstein, N. D. (1987). Taking care: understanding and encouraging self-protective behavior. New York: Cambridge University Press.CrossRef
48.
go back to reference Helmes, A. W., Bowen, D. J., & Bengel, J. (2002). Patient preferences of decision-making in the context of genetic testing for breast cancer risk. Genetics in Medicine, 4(3), 150–157.PubMedCrossRef Helmes, A. W., Bowen, D. J., & Bengel, J. (2002). Patient preferences of decision-making in the context of genetic testing for breast cancer risk. Genetics in Medicine, 4(3), 150–157.PubMedCrossRef
Metadata
Title
Effects of a Web-based intervention on women’s breast health behaviors
Authors
Deborah J Bowen, PhD
Robert Robbins, PhD
Nigel Bush, PhD
Hendrika Meischke, PhD
Abi Ludwig
Jean Wooldridge, MPH
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Translational Behavioral Medicine / Issue 1/2011
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-011-0028-0

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