Effects of an Internet Support System to Assist Cancer Patients in Reducing Symptom Distress: A Randomized Controlled Trial Effects of an online support group for prostate cancer survivors: a randomized trial. Efficiency, satisfaction, and costs for remote video visits following radical prostatectomy: a randomized controlled trial. The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: a multi-center randomized trial. Acceptability and Preliminary Feasibility of an Internet/CD-ROM-Based Education and Decision Program for Early-Stage Prostate Cancer Patients: Randomized Pilot Study Physical activity, sedentary behavior, and health-related quality of life in prostate cancer survivors in the health professionals follow-up study Responding to a significant recruitment challenge within three nationwide psychoeducational trials for cancer patients Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate Designing Tailored Internet Support to Assist Cancer Patients in Illness Management How User Characteristics Affect Use Patterns in Web-Based Illness Management Support for Patients with Breast and Prostate Cancer Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer. A randomized trial of internet‐based versus traditional sexual counseling for couples after localized prostate cancer treatment Development and utilization of complementary communication channels for treatment decision making and survivorship issues among cancer patients: The CIS Research Consortium Experience. Development and Evaluation of the Personal Patient Profile-Prostate (P3P), a Web-Based Decision Support System for Men Newly Diagnosed With Localized Prostate Cancer Decision preparation, satisfaction and regret in a multi-center sample of men with newly diagnosed localized prostate cancer. An online psychological intervention can improve the sexual satisfaction of men following treatment for localized prostate cancer: outcomes of a Randomised Controlled Trial evaluating My Road Ahead Cancer Patient and Survivor Research From the Cancer Information Service Research Consortium: A Preview of Three Large Randomized Trials and Initial Lessons Learned Decision Support with the Personal Patient Profile‐Prostate: A Multicenter Randomized Trial
Background : Cancer patients experience many physical and psychosocial problems for which they need support . WebChoice is an Internet-based , interactive health communication application that allows cancer patients to monitor their symptoms and problems , provides individually tailored information and self-management support , e-communication with expert cancer nurses , and an e-forum for group discussion with other patients . Objective : The objective of this study was to examine the effects of WebChoice on symptom distress ( primary outcome ) , depression , self-efficacy , health-related quality of life , and social support ( secondary outcomes ) . Methods : In this 1-year repeated- measures r and omized controlled trial , 325 breast and prostate cancer patients were r and omized into 1 experimental group  with access to WebChoice and 1 control group who received URLs of publicly available cancer Web sites . Results : Group differences on symptom distress were significant only for the global symptom distress index on the Memorial Symptom Assessment Scale ( slope estimate , −0.052 [ 95 % confidence interval , −0.101 to −0.004 ] ; t = 4.42 ; P = .037 ) . There were no significant group differences on secondary outcomes . Additional analyses showed significant within-group improvements in depression in the experimental group only . In the control group , self-efficacy and health-related quality of life deteriorated significantly over time . Conclusion : This r and omized controlled trial is one of the first to evaluate effects of an interactive health communication application to support cancer patients in illness management on symptoms . Although only 1 hypothesis was partially supported , the combined results show a clear trend toward better scores in the intervention group on most outcome measures . Implication s for Practice : If findings can be supported with additional research , WebChoice may become an important tool to support nursing care that can equip cancer patients to better manage their illness This longitudinal study evaluated the effect a prostate cancer-specific online support group had for self-assessed quality of life .  Participants ( N = 40 ) were r and omly assigned to an online support group or the control group . Data consisted of four previously vali date d quality -of-life measurements . Analysis determined that over time , quality of life improved for those in the online group and decreased for those in the control group , but returned to baseline at eight weeks . Providing support using online methods is effective ; the length of time this intervention should be provided to patients will require further research BACKGROUND Telemedicine in an ambulatory surgical population remains incompletely evaluated . OBJECTIVE To investigate patient encounters in the outpatient setting using video visit ( VV ) technology compared to traditional office visits ( OVs ) . DESIGN , SETTING , AND PARTICIPANTS From June 2013 to March 2014 , 55 prescreened men with a history of prostate cancer were prospect ively r and omized . VVs , with the patient at home or at work , were included in the outpatient clinic calendar of urologists . INTERVENTION Remote VV versus traditional OV . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS An equivalence analysis was used to assess the primary outcome , visit efficiency as measured by time studies . Secondary outcomes were patient/provider satisfaction and costs . RESULTS AND LIMITATIONS There were 28 VVs and 27 OVs . VVs were equivalent in efficiency to relative to OVs , as measured by patient-provider face time ( mean 14.5 vs 14.3min ; p=0.96 ) , patient wait time ( 18.4 vs 13.0min ; p=0.20 ) , and total time devoted to care ( 17.9 vs 17.8min ; p=0.97 ) . There were no significant differences in patient perception of visit confidentiality , efficiency , education quality , or overall satisfaction . VVs incurred lower costs , including distance traveled ( median 0 vs 95 miles ) , travel time ( 0 vs 95min ) , missed work ( 0 vs 1 d ) , and money spent on travel ( $ 0 vs $ 48 ; all p<0.0001 ) . There was a high level of urologist satisfaction for both VVs ( 88 % ) and OVs ( 90 % ) . The major limitation was sample size . CONCLUSIONS VV in the ambulatory postprostatectomy setting may have a future role in health care delivery models . We found equivalent efficiency , similar satisfaction , but significantly reduced patient costs for VV compared to OV . Further prospect i ve analyses are warranted . PATIENT SUMMARY Among men with surgically treated prostate cancer , we evaluated the utility of remote video visits compared to office visits for outpatient consultation with a urologist . Video visits were associated with equivalent efficiency , similar satisfaction , and significantly lower patient costs when compared to office visits . We conclude that video visits may have a future role in health care delivery models OBJECTIVE The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate , vs. usual education alone , on conflict associated with decision making , plus explore time-to-treatment , and treatment choice . METHODS A r and omized , multi-center clinical trial was conducted with measures at baseline , 1- , and 6 months . Men with newly diagnosed localized prostate cancer ( CaP ) who sought consultation at urology , radiation oncology , or multi-disciplinary clinics in 4 geographically-distinct American cities were recruited . Intervention group participants used the Personal Patient Profile-Prostate , a decision support system comprised of customized text and video coaching regarding potential outcomes , influential factors , and communication with care providers . The primary outcome , patient-reported decisional conflict , was evaluated over time using generalized estimating equations to fit generalized linear models . Additional outcomes , time-to-treatment , treatment choice , and program acceptability/usefulness , were explored . RESULTS A total of 494 eligible men were r and omized ( 266 intervention ; 228 control ) . The intervention reduced adjusted decisional conflict over time compared with the control group , for the uncertainty score ( estimate -3.61 ; ( confidence interval , -7.01 , 0.22 ) , and values clarity ( estimate -3.57 ; confidence interval ( -5.85,-1.30 ) . Borderline effect was seen for the total decisional conflict score ( estimate -1.75 ; confidence interval ( -3.61,0.11 ) . Time-to-treatment was comparable between groups , while undecided men in the intervention group chose brachytherapy more often than in the control group . Acceptability and usefulness were highly rated . CONCLUSION The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a CaP treatment that is consistent with the patient values and preferences Background Prostate cancer is the most common cancer affecting men in the United States . Management options for localized disease exist , yet an evidence -based criterion st and ard for treatment still has to emerge . Although 5-year survival rates approach 98 % , all treatment options carry the possibility for significant side effects , such as erectile dysfunction and urinary incontinence . It is therefore recommended that patients be actively involved in the treatment decision process . We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System ( PIES ) to enhance patients ’ treatment decision making . PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface , using videos , animations , graphics , and texts . Objectives ( 1 ) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis , and ( 2 ) to explore the potential impact of tailoring PIES treatment information to participants ’ information-seeking styles on study outcomes . Methods Participants ( n = 72 ) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision . Patients were r and omly assigned to 3 experimental conditions : ( 1 ) control condition ( providing information through st and ard National Cancer Institute brochures ; 26 % ) , and PIES ( 2 ) with tailoring ( 43 % ) and ( 3 ) without tailoring to a patient ’s information-seeking style ( 31 % ) . Question naires were administrated before ( t1 ) and immediately after the intervention ( t2 ) . Measurements include evaluation and acceptability of the PIES intervention , monitoring/blunting information-seeking style , psychological distress , and decision-related variables ( eg , decisional confidence , feeling informed about prostate cancer and treatment , and treatment preference ) . Results The PIES program was well accepted by patients and did not interfere with the clinical routine . About 79 % of eligible patients ( 72/91 ) completed the pre- and post-PIES intervention assessment s. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices , higher levels of helpfulness of the information they received in making a treatment decision , and that the information they received was emotionally reassuring . Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options , were less anxious about their treatment choices , and thought the information they received was clear ( P < .05 ) . Tailoring PIES information to information-seeking style was not related to decision-making variables . Conclusions This pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer . PIES improved key decision-making process variables and reduced the emotional impact of a difficult medical decision Purpose Many prostate cancer survivors experience compromised health-related quality of life ( HRQOL ) as a result of prostate cancer . We examined relationships between types and intensities of activity and sedentary behavior  and prostate cancer-related HRQOL , overall , and by demographic , disease , and treatment characteristics . Methods Associations between post-diagnosis activity and sedentary behavior  and HRQOL domains ( urinary incontinence , urinary irritation/obstruction , bowel , sexual , and vitality/hormonal ) were prospect ively examined in men diagnosed with non-metastatic prostate cancer in the Health Professionals Follow-up Study ( n = 1917 ) using generalized linear models . Results After adjusting for potential confounders , higher duration of total , non-vigorous , and walking activity was associated with higher vitality/hormonal functioning scores ( p-trends , < 0.0001 ) . Effects were small ( d = 0.16–0.20 ) but approached clinical significance for men in the highest vs. lowest activity categories . Survivors who walked ≥90 min/week at a normal pace , or faster , reported higher hormone/vitality scores ( p = 0.001 ) than men walking < 90 min at an easy pace . Weightlifting was associated with increased urinary incontinence ( p-trend , 0.02 ) . Total activity was associated with higher hormone/vitality functioning in men who were ≥5 years post-treatment , had more advanced disease ( Gleason score ≥7 ) , and had ≥1 comorbid condition . No relationships were observed between vigorous activity or sedentary behavior and HRQOL . Conclusions Increased duration of  non-vigorous  activity and walking post-diagnosis was positively associated with better hormone/vitality functioning . Specifically , engaging in ≥5 h of non-vigorous activity or ≥3 h of walking per week may be beneficial . Implication s for Cancer SurvivorsEncouraging men to engage in non-vigorous activity and walking may be helpful for managing prostate cancer-related HRQOL Purpose When faced with a significant recruitment challenge for three nationwide psychoeducational trials targeting prostate and breast cancer patients , the Cancer Information Service Research Consortium initiated outreach efforts to increase accrual . Recruitment is reported by major outreach strategy to inform the use of similar campaigns , either as primary recruitment efforts or to supplement “ in-reach ” recruitment within oncology setting s. Methods During a 33-month period , recruitment was tracked from the National Cancer Institute ’s Cancer Information Service ( CIS ) , the American Cancer Society ( ACS ) , Dr. Susan Love Research Foundation ’s Love/Avon Army of Women ( AOW ) , Internet advertising , press releases , radio/television interviews , recruitment material s in community venues , and outreach to churches and cancer support organizations . Results Across projects , the majority ( 89 % ) of recruited participants ( N = 2,134 ) was obtained from the CIS ( n = 901 , 19 months of recruitment ) , AOW ( n = 869 , 18 months ) , and ACS ( n = 123 , 12 months ) . Other efforts showed minimal gain in recruitment . Conclusions Cancer information programs ( e.g. , CIS and ACS ) and registries of individuals willing to participate in cancer-related research ( e.g. , AOW ) can represent exceptional re sources for outreach recruitment of cancer patients , especially when the eligibility criteria are highly restrictive . However , these re sources do not yield sample s representative of the larger population of adults diagnosed with cancer , and conclusions from such trials must be tempered accordingly . Implication s for cancer survivorsInadequate recruitment to r and omized controlled trials limits the creation of useful interventions for cancer survivors . By enrolling in cancer registries and taking part in research , cancer survivors can contribute to the development of effective re sources for the survivor population Background According to the CONSORT statement , significance testing of baseline differences in r and omized controlled trials should not be performed . In fact , this practice has been discouraged by numerous authors throughout the last forty years . During that time span , reporting of baseline differences has substantially decreased in the leading general medical journals . Our own experience in the field of nutrition behavior research however , is that co- authors , review ers and even editors are still very persistent in their dem and for these tests . The aim of this paper is therefore to negate this dem and by providing clear evidence as to why testing for baseline differences between intervention groups statistically is superfluous and why such results should not be published . Discussion Testing for baseline differences is often propagated because of the belief that it shows whether r and omization was successful and it identifies real or important differences between treatment arms that should be accounted for in the statistical analyses . Especially the latter argument is flawed , because it ignores the fact that the prognostic strength of a variable is also important when the interest is in adjustment for confounding . In addition , including prognostic variables as covariates can increase the precision of the effect estimate . This means that choosing covariates based on significance tests for baseline differences might lead to omissions of important covariates and , less importantly , to inclusion of irrelevant covariates in the analysis . We used data from four supermarket trials on the effects of pricing strategies on fruit and vegetables purchases , to show that results from fully adjusted analyses sometimes do appreciably differ from results from analyses adjusted for significant baseline differences only . We propose to adjust for known or anticipated important prognostic variables . These could or should be pre-specified in trial protocol s. Subsequently , authors should report results from the fully adjusted as well as crude analyses , especially for dichotomous and time to event data . Summary Based on our arguments , which were illustrated by our findings , we propose that journals in and outside the field of nutrition behavior actively adopt the CONSORT 2010 statement on this topic by not publishing significance tests for baseline differences anymore This paper describes the development and a preliminary usage analysis of a novel Internet-based support system that assists cancer patients in symptom monitoring and disease management . The system , called WebChoice , allows patients to monitor symptoms over time , and provides access to evidence -based self-management options tailored to their reported symptoms as well as a communication area where patients can ask questions to a clinical nurse specialist and exchange experiences with other cancer patients . A currently ongoing r and omized clinical trial evaluates effects of WebChoice on patient outcomes . This paper describes essential features of WebChoice , steps we used to design it as user-friendly as possible ; and preliminary findings on patients use Background Frequently eHealth applications are not used as intended and they have high attrition rates ; therefore , a better underst and ing of patients ’ need for support is warranted . Specifically , more research is needed to identify which system components target different patient groups and under what conditions . Objective To explore user characteristics associated with the use of different system components of a Web-based illness management support system for cancer patients ( WebChoice ) . Methods For this secondary post hoc analysis of a large r and omized controlled trial ( RCT ) , in which WebChoice was tested among 325 breast cancer and prostate cancer patients who were followed with repeated measures for 1 year , usage patterns of 162 cancer patients in the intervention arm with access to WebChoice  were extracted from the user log . Logistic regression was performed to identify patterns of associations between system use and patient characteristics . Latent class analyses ( LCA ) were performed to identify associations among the use of different system components and levels of social support , symptom distress , depression , self-efficacy , and health-related quality of life . Results Approximately two-thirds ( 103/162 , 63.6 % ) of the patients logged on to WebChoice more than once , and were defined as users . A high level of computer experience ( odds ratio [ OR ] 3.77 , 95 % CI 1.20 - 11.91 ) and not having other illnesses in addition to cancer ( OR 2.10 , 95 % CI 1.02 - 4.34 ) increased the overall probability of using WebChoice . LCA showed that both men with prostate cancer and women with breast cancer who had low scores on social support accompanied with high levels of symptom distress and high levels of depression were more likely to use the e-message component . For men with prostate cancer , these variables were also associated with high use of the self-management advice component .  We found important differences between men with prostate cancer and women with breast cancer when associations between WebChoice use and each user characteristic were analyzed separately . High use of all components was associated with low levels of social support among women with breast cancer , but not among men with prostate cancer . High use of e-messages , advice , and the discussion forum were associated with high levels of depression among women with breast cancer , but not among men with prostate cancer . For men with prostate cancer ( but not women with breast cancer ) , high use of symptom assessment s , advice , and the discussion forum were associated with high levels of symptom distress . However , it is unclear whether these findings can be attributed to differences related to diagnosis , gender , or both . Conclusions This study provides evidence that different user characteristics are associated with different use patterns . Such information is crucial to target Web-based support systems to different patient groups . LCA is a useful technique to identify subgroups of users . In our study ,  e-messages and self-management advice  were highly used components for patients who had low levels of social support and high illness burden , suggesting that patients with these characteristics may find such tools particularly useful . Trial Registration Clinical Trials.gov NCT00710658 ; http:// clinical trials.gov/ct2/show/NCT00710658 ( Archived by WebCite at http://www.webcitation.org/6EmEWZiwz BACKGROUND Prostate cancer ( PCa ) poses many emotional and physical challenges for men following treatment . The unmet support needs of these men are well documented , and access to psychosocial support remains problematic . OBJECTIVES To assess the efficacy of an online psychological intervention for men who have localised PCa . DESIGN , SETTING , AND PARTICIPANTS We undertook a r and omised controlled trial to evaluate the intervention . Participants were r and omly allocated to one of three conditions :  My Road Ahead ( MRA ) alone ( MRA Only ) , MRA plus access to an online forum ( MRA+Forum ) , and access to the forum alone ( Forum ) . INTERVENTION The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules design ed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Pre- and postintervention assessment s of psychological distress ( the 21- question Depression , Anxiety and Stress Scale ) [ 1 ] and the Prostate Cancer-related Quality of Life scale [ 2 ] were conducted . Multivariate analysis of variance , regression , and structural equation modelling were used to analyse the data . RESULTS AND LIMITATIONS In total , 142 participants were r and omly allocated to one of the three intervention arms . The mean age of participants was 61 yr of age ( st and ard deviation : 7 ) , and 88 % had undergone radical prostatectomy . A significant improvement in psychological distress was observed for participants who had access to the combined condition ( MRA+Forum ) with a moderate effect size ( p=0.02 ; partial η(2)=0.07 ) . In particular , the decline in the mean level of psychological distress was 8.8 units larger for the MRA+Forum group than the Forum group ( 95 % confidence interval [ CI ] , 0.9 - 16.7 ) . Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA+Forum group than for the MRA Only group , this difference was not significant ( 95 % CI , 1.1 - 15.1 ) . Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA+Forum condition . CONCLUSIONS This study is the first , to our knowledge , that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa . The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive . PATIENT SUMMARY This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone After treatment for prostate cancer , multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction ( ED ) . The authors of this report conducted a r and omized trial comparing traditional or internet‐based sexual counseling with waitlist ( WL ) control OBJECTIVE Cancer patients and survivors are assuming active roles in decision-making and digital patient support tools are widely used to facilitate patient engagement . As part of Cancer Information Service Research Consortium 's r and omized controlled trials focused on the efficacy of eHealth interventions to promote informed treatment decision-making for newly diagnosed prostate and breast cancer patients , and post-treatment breast cancer , we conducted a rigorous process evaluation to examine the actual use of and perceived benefits of two complementary communication channels -- print and eHealth interventions . METHODS The three Virtual Cancer Information Service ( V-CIS ) interventions were developed through a rigorous developmental process , guided by self-regulatory theory , informed decision-making frameworks , and health communications best practice s. Control arm participants received NCI print material s ; experimental arm participants received the additional V-CIS patient support tool . Actual usage data from the web-based V-CIS was also obtained and reported . RESULTS Print material s were highly used by all groups . About 60 % of the experimental group reported using the V-CIS . Those who did use the V-CIS rated it highly on improvements in knowledge , patient-provider communication and decision-making . CONCLUSION The findings show that how patients actually use eHealth interventions either singularly or within the context of other communication channels is complex . PRACTICE IMPLICATION S Integrating rigorous best practice s and theoretical foundations is essential and multiple communication approaches should be considered to support patient preferences Background Given that no other disease with the high incidence of localized prostate cancer ( LPC ) has so many treatments with so few certainties related to outcomes , many men are faced with assuming some responsibility for the treatment decision along with guidance from clinicians . Men strongly consider their own personal characteristics and other personal factors as important and influential to the decision . Clinical research ers have not developed or comprehensively investigated interventions to facilitate the insight and prioritizing of personal factors along with medical factors that are required of a man in preparation for the treatment decision . Objectives The purpose of this pilot study was to develop and evaluate the feasibility and usability of a  Web-based decision support technology , the Personal Patient Profile-Prostate ( P3P ) , in men newly diagnosed with LPC . Methods Use cases were developed followed by infrastructure and content application . The program was provided on a personal desktop computer with a touch screen monitor . Participant responses to the query component of P3P determined the content of the multimedia educational and coaching intervention . The intervention was tailored to race , age , and personal factors reported as influencing the decision . Prepilot usability testing was conducted using a “ think aloud ” interview to identify navigation and content challenges . These issues were addressed prior to deployment in the clinic . A clinical pilot was conducted in an academic medical center where men sought consultation and treatment for LPC . Completion time , missing data , and acceptability were measured . Results Prepilot testing included 4 men with a past diagnosis of LPC who had completed therapy .  Technical navigation issues were documented along with confusing content language . A total of 30 additional men with a recent diagnosis of LPC completed the P3P program in clinic prior to consulting with a urologist regarding treatment options . In a mean time of 46 minutes ( SD 13 minutes ) , participants completed the P3P query and intervention components . Of a possible 4560 items for 30 participants , 22 ( 0.5 % ) were missing . Acceptability was reported as high overall . The sections of the intervention reported as most useful were the statistics graphs , priority information topics , and annotated external website links . Conclusions The P3P intervention is a feasible and usable program to facilitate treatment decision making by men with newly diagnosed LPC . Testing in a multisite r and omized trial with a diverse sample is warranted OBJECTIVE To describe relationships between use of the Personal Patient Profile-Prostate ( P3P ) decision support system and patient characteristics , and perceived preparation for decision making ( PrepDM ) , satisfaction and decisional regret in the context of prostate cancer treatment choice . METHODS 494 men with localized prostate cancer ( LPC ) were r and omized to receive the P3P intervention or usual care and completed pre-treatment , 1-month and 6-month outcome measures . Multivariable linear regression models were fit for each outcome . RESULTS Physician consult visits prior to enrollment , race/ethnicity , and use of clinic-provided books were significant predictors of perceived PrepDM at 1 month . Prior Internet use and PrepDM significantly predicted 6-month decision satisfaction . Decisional regret was significantly predicted by demographics , anxiety , PrepDM score , and EPIC bowel domain score at 6 months . Use of P3P did not predict any outcome . CONCLUSION While the P3P intervention did not significantly affect the outcomes , pre-enrollment information and preparation were strong predictors of the 1- and 6-month outcomes . Decision regret was significantly influenced by personal characteristics and post-treatment symptoms/side effects . PRACTICE IMPLICATION S Information received and used between biopsy and the treatment options consult visit is likely to make a difference in decision satisfaction BACKGROUND Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment ; however , many men report difficulty in accessing appropriate care . METHODS A r and omized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead ( MRA ) for men with localized prostate cancer in improving sexual satisfaction . Participants were r and omized to 1 of 3 conditions MRA alone or MRA plus online forum , or forum access alone .  Pre , post , and follow-up assessment s of overall sexual satisfaction were conducted . Mixed models and structural equation modeling were used to analyze the data . RESULTS One hundred forty-two men ( mean age 61 y ; SD = 7 ) participated . The majority of participants had undergone radical prostatectomy ( 88 % ) and all men had received treatment for localized prostate cancer . Significant differences were obtained for the 3 groups ( P = .026 ) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size ( P = .004 , partial η2 = 0.256 ) . Structural equation modeling indicated that increases in sexual function , masculine self-esteem , and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition . CONCLUSIONS This study is the first , to our knowledge , that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer . The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes The authors describe 3 large r and omized trials from the Cancer Information Service Research Consortium . Three web-based multimedia programs are being tested to help newly diagnosed prostate ( Project 1 ) and breast cancer patients ( Project 2 ) make informed treatment decisions and breast cancer patients prepare for life after treatment ( Project 3 ) . Project 3 also tests a telephone callback intervention delivered by a cancer information specialist . All participants receive st and ard print material specific to each project . Preliminary results from the 2-month follow-up interviews are reported for the initial wave of enrolled participants , most of whom were recruited from the Cancer Information Service ( 1 - 800 - 4-CANCER ) telephone information program ( Project 1 : n = 208 ; Project 2 : n = 340 ; Project 3 : n = 792 ) .  Self-reported use of the multimedia program  was 51 % , 52 % , and 67 % for Projects 1 , 2 , and 3 , respectively . Self-reported use of the print material s ( read all , most , or some ) was 90 % , 85 % , and 83 % for Projects 1 , 2 , and 3 , respectively . The  callback intervention  was completed by 92 % of Project 3 participants . Among those using the Cancer Information Service Research Consortium interventions , perceived usefulness and benefit was high , and more than 90 % reported that they would recommend them to other cancer patients . The authors present 5 initial lessons learned that may help inform future cancer communications research Purpose We evaluated the efficacy of the web based P3P ( Personal Patient Profile‐Prostate ) decision aid vs usual care with regard to decisional conflict in men with localized prostate cancer . Material s and Methods A r and omized ( 1:1 ) , controlled , parallel group , nonblinded trial was performed in 4 regions of the United States . Eligible men had clinical ly localized prostate cancer and an upcoming consultation , and they spoke and read English or Spanish . Participants answered question naires to report decision making stage , personal characteristics , concerns and preferences plus baseline symptoms and decisional conflict . A r and omization algorithm allocated participants to receive tailored education and communication coaching , generic teaching sheets and external websites plus a 1‐page summary to clinicians ( intervention ) or the links plus material s provided in clinic ( usual care ) . Conflict outcomes and the number of consultations were measured at 1 month . Univariate and multivariable models were used to analyze outcomes . Results A total of 392 men were r and omized , including 198 to intervention and 194 to usual care , of whom 152 and 153 , respectively , returned 1‐month outcomes .  The mean ± SD 1‐month decisional conflict scale ( score range 0 to 100 ) was 10.9 ± 16.7 for intervention and 9.9 ± 18.0 for usual care . The multivariable model revealed significantly reduced conflict in the intervention group ( –5.00 , 95 % CI –9.40––0.59 ) . Other predictors of conflict included income , marital or partner status , decision status , number of consultations , clinical site and D’Amico risk classification . Conclusions In this multicenter trial the decision aid significantly reduced decisional conflict . Other variables impacted conflict and modified the effect of the decision aid , notably risk classification , consultations and re sources . P3P is an effective adjunct for shared decision making in men with localized prostate cancer
Purpose To examine the feasibility , acceptability , and efficacy of online supportive care interventions targeting prostate cancer survivors ( PCS ) .