Impact of a primary care based intervention on breast cancer knowledge, risk perception and concern: A randomized, controlled trial

Jennifer Livaudais-Toman; Leah S Karliner; Jeffrey A Tice; Karla Kerlikowske; Steven Gregorich; Eliseo J Pérez-Stable; Rena J Pasick; Alice Chen; Jessica Quinn; Celia P Kaplan

doi:10.1016/j.breast.2015.09.009

Impact of a primary care based intervention on breast cancer knowledge, risk perception and concern: A randomized, controlled trial

Breast. 2015 Dec;24(6):758-66. doi: 10.1016/j.breast.2015.09.009. Epub 2015 Oct 21.

Affiliations

¹ Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA. Electronic address: jennifer.toman@ucsf.edu.
² Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
³ Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.
⁴ Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; General Internal Medicine Section, Department of Veterans Affairs, San Francisco, CA, USA.
⁵ Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
⁶ Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA.

Abstract

Purpose: To estimate the effects of a tablet-based, breast cancer risk education intervention for use in primary care settings (BreastCARE) on patients' breast cancer knowledge, risk perception and concern.

Methods: From June 2011-August 2012, we enrolled women from two clinics, aged 40-74 years with no personal breast cancer history, and randomized them to the BreastCARE intervention group or to the control group. All patients completed a baseline telephone survey and risk assessment (via telephone for controls, via tablet computer in clinic waiting room prior to visit for intervention). All women were categorized as high or average risk based on the Referral Screening Tool, the Gail model or the Breast Cancer Surveillance Consortium model. Intervention patients and their physicians received an individualized risk report to discuss during the visit. All women completed a follow-up telephone survey 1-2 weeks after risk assessment. Post-test comparisons estimated differences at follow-up in breast cancer knowledge, risk perception and concern.

Results: 580 intervention and 655 control women completed follow-up interviews. Mean age was 56 years (SD = 9). At follow-up, 73% of controls and 71% of intervention women correctly perceived their breast cancer risk and 22% of controls and 24% of intervention women were very concerned about breast cancer. Intervention patients had greater knowledge (≥75% correct answers) of breast cancer risk factors at follow-up (24% vs. 16%; p = 0.002). In multivariable analysis, there were no differences in correct risk perception or concern, but intervention patients had greater knowledge ([OR] = 1.62; 95% [CI] = 1.19-2.23).

Conclusions: A simple, practical intervention involving physicians at the point of care can improve knowledge of breast cancer without increasing concern.

Trial registration: ClinicalTrials.gov identifier NCT01830933.

Keywords: Breast cancer; Health-related information technology; Prevention; RCT; Risk reduction.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Breast Neoplasms / psychology*
Computers, Handheld
Consumer Health Information / methods*
Early Detection of Cancer / psychology*
Female
Health Knowledge, Attitudes, Practice*
Humans
Middle Aged
Perception
Primary Health Care / methods*
Referral and Consultation
Risk Assessment / methods
Risk Factors
Surveys and Questionnaires

Associated data

ClinicalTrials.gov/NCT01830933

Impact of a primary care based intervention on breast cancer knowledge, risk perception and concern: A randomized, controlled trial

Authors

Affiliations

Abstract

Publication types

MeSH terms

Associated data

Grants and funding