Tailored Web-Based Information for Younger and Older Patients with Cancer

Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes

M.H. Nguyen, Ellen M A Smets, Nadine Bol, E.F. Loos, Hanneke W. M. van Laarhoven, D. Geijsen, M. I. Van Berge Henegouwen, K.M.A.J. Tytgat, Julia C. M. Van Weert

Research output: Contribution to journalArticleScientificpeer-review

Abstract

BACKGROUND: Many patients with cancer, including older patients (aged ≥65 years), consult the Web to prepare for their doctor's visit. In particular, older patients have varying needs regarding the mode in which information is presented (eg, via textual, visual, or audiovisual modes) owing to age-related sensory (eg, impaired vision and hearing) and cognitive decline (eg, reduced processing speed). Therefore, Web-based information targeted at older patient populations is likely to be used and processed more effectively, and evaluated more positively, when tailored to age-related capabilities and preferences. This, in turn, may benefit patient outcomes.

OBJECTIVE: This randomized controlled trial tested the effects of a Web-based tailored educational intervention among newly diagnosed younger (<65 years) and older (≥65 years) patients with cancer. We compared the intervention group who viewed a mode-tailored website (ie, enabling patients to tailor information using textual, visual, and audiovisual modes) with 3 control groups view a nontailored website (ie, text only, text with images, and text with videos). We examined website experience outcomes (ie, website satisfaction, website involvement, knowledge, anxiety, and communication self-efficacy) and consultation experience outcomes (ie, question asking during consultation, anxiety, and information recall).

METHODS: Patients from a multidisciplinary outpatient clinic (N=232) viewed a mode-tailored or nontailored website as preparation before their hospital consultations to discuss diagnosis and treatment. Data were collected before (T1), during (T2), and after (T3) visitation. Website experience outcomes were assessed with questionnaires (T1). Patients' question asking was coded from videotaped consultations, and anxiety was assessed through a questionnaire (T2). Telephone interviews were conducted to assess knowledge acquired from the website before (T1) and after consultation (T3), and information recall from the consultation (T3).

RESULTS: The preparatory website was well used across all conditions (mean 34 min). Younger patients viewing the mode-tailored website were more satisfied before consultation (P=.02) and reported lower anxiety after consultation (P=.046; vs text only). This pattern was not found in older patients. Mode tailoring yielded no other significant differences in patient outcomes. Regression analyses showed that website involvement (beta=.15; P=.03) and, to a lesser extent, website satisfaction (beta=.15; P=.05) positively associated with knowledge before consultation (T1). In turn, higher knowledge before consultation (beta=.39; P<.001), together with time on the website (beta=.21; P=.002; T1), predicted information recall from consultations (T3). Patients with higher knowledge before consultation (T1) also reported higher knowledge from the website afterward (T3; beta=.22; P=.003).

CONCLUSIONS: Offering preparatory online information before consultations benefits information processing and patient outcomes of both younger and older newly diagnosed patients with cancer. Younger patients benefit even more when information is offered in a mode-tailored manner. We discuss the theoretical, methodological, and practical implications for patient-provider communication research in an electronic health era.

CLINICAL TRIAL: Netherlands Trial Register NTR5904; https://www.trialregister.nl/trial/5750.

Original languageEnglish
Article number14407
Pages (from-to)e14407
Number of pages24
JournalJournal of Medical Internet Research (JMIR)
Volume21
Issue number10
DOIs
Publication statusPublished - 1 Oct 2019

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Neoplasms
Communication
Ambulatory Care Facilities
Netherlands
Hearing
Interviews

Keywords

  • ANXIETY
  • COMMUNICATION
  • DECISION-MAKING
  • HEALTH
  • QUALITY-OF-LIFE
  • QUESTION PROMPT
  • RECALL
  • SEEKING
  • VALIDATION
  • WEBSITE SATISFACTION
  • Web-based tailoring
  • aging
  • anxiety
  • audiovisual media
  • cancer
  • consultation
  • health communication
  • internet
  • memory
  • patient education
  • patient participation
  • patient reported outcomes
  • randomized controlled trial

Cite this

Nguyen, M.H. ; Smets, Ellen M A ; Bol, Nadine ; Loos, E.F. ; van Laarhoven, Hanneke W. M. ; Geijsen, D. ; Van Berge Henegouwen, M. I. ; Tytgat, K.M.A.J. ; Van Weert, Julia C. M. / Tailored Web-Based Information for Younger and Older Patients with Cancer : Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes. In: Journal of Medical Internet Research (JMIR). 2019 ; Vol. 21, No. 10. pp. e14407.
@article{d5ddd2a6d3d54eb1b2ea324ad5ac74b9,
title = "Tailored Web-Based Information for Younger and Older Patients with Cancer: Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes",
abstract = "BACKGROUND: Many patients with cancer, including older patients (aged ≥65 years), consult the Web to prepare for their doctor's visit. In particular, older patients have varying needs regarding the mode in which information is presented (eg, via textual, visual, or audiovisual modes) owing to age-related sensory (eg, impaired vision and hearing) and cognitive decline (eg, reduced processing speed). Therefore, Web-based information targeted at older patient populations is likely to be used and processed more effectively, and evaluated more positively, when tailored to age-related capabilities and preferences. This, in turn, may benefit patient outcomes.OBJECTIVE: This randomized controlled trial tested the effects of a Web-based tailored educational intervention among newly diagnosed younger (<65 years) and older (≥65 years) patients with cancer. We compared the intervention group who viewed a mode-tailored website (ie, enabling patients to tailor information using textual, visual, and audiovisual modes) with 3 control groups view a nontailored website (ie, text only, text with images, and text with videos). We examined website experience outcomes (ie, website satisfaction, website involvement, knowledge, anxiety, and communication self-efficacy) and consultation experience outcomes (ie, question asking during consultation, anxiety, and information recall).METHODS: Patients from a multidisciplinary outpatient clinic (N=232) viewed a mode-tailored or nontailored website as preparation before their hospital consultations to discuss diagnosis and treatment. Data were collected before (T1), during (T2), and after (T3) visitation. Website experience outcomes were assessed with questionnaires (T1). Patients' question asking was coded from videotaped consultations, and anxiety was assessed through a questionnaire (T2). Telephone interviews were conducted to assess knowledge acquired from the website before (T1) and after consultation (T3), and information recall from the consultation (T3).RESULTS: The preparatory website was well used across all conditions (mean 34 min). Younger patients viewing the mode-tailored website were more satisfied before consultation (P=.02) and reported lower anxiety after consultation (P=.046; vs text only). This pattern was not found in older patients. Mode tailoring yielded no other significant differences in patient outcomes. Regression analyses showed that website involvement (beta=.15; P=.03) and, to a lesser extent, website satisfaction (beta=.15; P=.05) positively associated with knowledge before consultation (T1). In turn, higher knowledge before consultation (beta=.39; P<.001), together with time on the website (beta=.21; P=.002; T1), predicted information recall from consultations (T3). Patients with higher knowledge before consultation (T1) also reported higher knowledge from the website afterward (T3; beta=.22; P=.003).CONCLUSIONS: Offering preparatory online information before consultations benefits information processing and patient outcomes of both younger and older newly diagnosed patients with cancer. Younger patients benefit even more when information is offered in a mode-tailored manner. We discuss the theoretical, methodological, and practical implications for patient-provider communication research in an electronic health era.CLINICAL TRIAL: Netherlands Trial Register NTR5904; https://www.trialregister.nl/trial/5750.",
keywords = "ANXIETY, COMMUNICATION, DECISION-MAKING, HEALTH, QUALITY-OF-LIFE, QUESTION PROMPT, RECALL, SEEKING, VALIDATION, WEBSITE SATISFACTION, Web-based tailoring, aging, anxiety, audiovisual media, cancer, consultation, health communication, internet, memory, patient education, patient participation, patient reported outcomes, randomized controlled trial",
author = "M.H. Nguyen and Smets, {Ellen M A} and Nadine Bol and E.F. Loos and {van Laarhoven}, {Hanneke W. M.} and D. Geijsen and {Van Berge Henegouwen}, {M. I.} and K.M.A.J. Tytgat and {Van Weert}, {Julia C. M.}",
note = "{\circledC}Minh Hao Nguyen, Ellen MA Smets, Nadine Bol, Eug{\`e}ne F Loos, Hanneke WM van Laarhoven, Debby Geijsen, Mark I van Berge Henegouwen, Kristien MAJ Tytgat, Julia CM van Weert. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.10.2019.",
year = "2019",
month = "10",
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doi = "http://dx.doi.org/10.2196/14407",
language = "English",
volume = "21",
pages = "e14407",
journal = "Journal of Medical Internet Research (JMIR)",
issn = "1438-8871",
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Nguyen, MH, Smets, EMA, Bol, N, Loos, EF, van Laarhoven, HWM, Geijsen, D, Van Berge Henegouwen, MI, Tytgat, KMAJ & Van Weert, JCM 2019, 'Tailored Web-Based Information for Younger and Older Patients with Cancer: Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes', Journal of Medical Internet Research (JMIR), vol. 21, no. 10, 14407, pp. e14407. https://doi.org/10.2196/14407

Tailored Web-Based Information for Younger and Older Patients with Cancer : Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes. / Nguyen, M.H.; Smets, Ellen M A; Bol, Nadine; Loos, E.F.; van Laarhoven, Hanneke W. M.; Geijsen, D.; Van Berge Henegouwen, M. I.; Tytgat, K.M.A.J.; Van Weert, Julia C. M.

In: Journal of Medical Internet Research (JMIR), Vol. 21, No. 10, 14407, 01.10.2019, p. e14407.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Tailored Web-Based Information for Younger and Older Patients with Cancer

T2 - Randomized Controlled Trial of a Preparatory Educational Intervention on Patient Outcomes

AU - Nguyen, M.H.

AU - Smets, Ellen M A

AU - Bol, Nadine

AU - Loos, E.F.

AU - van Laarhoven, Hanneke W. M.

AU - Geijsen, D.

AU - Van Berge Henegouwen, M. I.

AU - Tytgat, K.M.A.J.

AU - Van Weert, Julia C. M.

N1 - ©Minh Hao Nguyen, Ellen MA Smets, Nadine Bol, Eugène F Loos, Hanneke WM van Laarhoven, Debby Geijsen, Mark I van Berge Henegouwen, Kristien MAJ Tytgat, Julia CM van Weert. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.10.2019.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - BACKGROUND: Many patients with cancer, including older patients (aged ≥65 years), consult the Web to prepare for their doctor's visit. In particular, older patients have varying needs regarding the mode in which information is presented (eg, via textual, visual, or audiovisual modes) owing to age-related sensory (eg, impaired vision and hearing) and cognitive decline (eg, reduced processing speed). Therefore, Web-based information targeted at older patient populations is likely to be used and processed more effectively, and evaluated more positively, when tailored to age-related capabilities and preferences. This, in turn, may benefit patient outcomes.OBJECTIVE: This randomized controlled trial tested the effects of a Web-based tailored educational intervention among newly diagnosed younger (<65 years) and older (≥65 years) patients with cancer. We compared the intervention group who viewed a mode-tailored website (ie, enabling patients to tailor information using textual, visual, and audiovisual modes) with 3 control groups view a nontailored website (ie, text only, text with images, and text with videos). We examined website experience outcomes (ie, website satisfaction, website involvement, knowledge, anxiety, and communication self-efficacy) and consultation experience outcomes (ie, question asking during consultation, anxiety, and information recall).METHODS: Patients from a multidisciplinary outpatient clinic (N=232) viewed a mode-tailored or nontailored website as preparation before their hospital consultations to discuss diagnosis and treatment. Data were collected before (T1), during (T2), and after (T3) visitation. Website experience outcomes were assessed with questionnaires (T1). Patients' question asking was coded from videotaped consultations, and anxiety was assessed through a questionnaire (T2). Telephone interviews were conducted to assess knowledge acquired from the website before (T1) and after consultation (T3), and information recall from the consultation (T3).RESULTS: The preparatory website was well used across all conditions (mean 34 min). Younger patients viewing the mode-tailored website were more satisfied before consultation (P=.02) and reported lower anxiety after consultation (P=.046; vs text only). This pattern was not found in older patients. Mode tailoring yielded no other significant differences in patient outcomes. Regression analyses showed that website involvement (beta=.15; P=.03) and, to a lesser extent, website satisfaction (beta=.15; P=.05) positively associated with knowledge before consultation (T1). In turn, higher knowledge before consultation (beta=.39; P<.001), together with time on the website (beta=.21; P=.002; T1), predicted information recall from consultations (T3). Patients with higher knowledge before consultation (T1) also reported higher knowledge from the website afterward (T3; beta=.22; P=.003).CONCLUSIONS: Offering preparatory online information before consultations benefits information processing and patient outcomes of both younger and older newly diagnosed patients with cancer. Younger patients benefit even more when information is offered in a mode-tailored manner. We discuss the theoretical, methodological, and practical implications for patient-provider communication research in an electronic health era.CLINICAL TRIAL: Netherlands Trial Register NTR5904; https://www.trialregister.nl/trial/5750.

AB - BACKGROUND: Many patients with cancer, including older patients (aged ≥65 years), consult the Web to prepare for their doctor's visit. In particular, older patients have varying needs regarding the mode in which information is presented (eg, via textual, visual, or audiovisual modes) owing to age-related sensory (eg, impaired vision and hearing) and cognitive decline (eg, reduced processing speed). Therefore, Web-based information targeted at older patient populations is likely to be used and processed more effectively, and evaluated more positively, when tailored to age-related capabilities and preferences. This, in turn, may benefit patient outcomes.OBJECTIVE: This randomized controlled trial tested the effects of a Web-based tailored educational intervention among newly diagnosed younger (<65 years) and older (≥65 years) patients with cancer. We compared the intervention group who viewed a mode-tailored website (ie, enabling patients to tailor information using textual, visual, and audiovisual modes) with 3 control groups view a nontailored website (ie, text only, text with images, and text with videos). We examined website experience outcomes (ie, website satisfaction, website involvement, knowledge, anxiety, and communication self-efficacy) and consultation experience outcomes (ie, question asking during consultation, anxiety, and information recall).METHODS: Patients from a multidisciplinary outpatient clinic (N=232) viewed a mode-tailored or nontailored website as preparation before their hospital consultations to discuss diagnosis and treatment. Data were collected before (T1), during (T2), and after (T3) visitation. Website experience outcomes were assessed with questionnaires (T1). Patients' question asking was coded from videotaped consultations, and anxiety was assessed through a questionnaire (T2). Telephone interviews were conducted to assess knowledge acquired from the website before (T1) and after consultation (T3), and information recall from the consultation (T3).RESULTS: The preparatory website was well used across all conditions (mean 34 min). Younger patients viewing the mode-tailored website were more satisfied before consultation (P=.02) and reported lower anxiety after consultation (P=.046; vs text only). This pattern was not found in older patients. Mode tailoring yielded no other significant differences in patient outcomes. Regression analyses showed that website involvement (beta=.15; P=.03) and, to a lesser extent, website satisfaction (beta=.15; P=.05) positively associated with knowledge before consultation (T1). In turn, higher knowledge before consultation (beta=.39; P<.001), together with time on the website (beta=.21; P=.002; T1), predicted information recall from consultations (T3). Patients with higher knowledge before consultation (T1) also reported higher knowledge from the website afterward (T3; beta=.22; P=.003).CONCLUSIONS: Offering preparatory online information before consultations benefits information processing and patient outcomes of both younger and older newly diagnosed patients with cancer. Younger patients benefit even more when information is offered in a mode-tailored manner. We discuss the theoretical, methodological, and practical implications for patient-provider communication research in an electronic health era.CLINICAL TRIAL: Netherlands Trial Register NTR5904; https://www.trialregister.nl/trial/5750.

KW - ANXIETY

KW - COMMUNICATION

KW - DECISION-MAKING

KW - HEALTH

KW - QUALITY-OF-LIFE

KW - QUESTION PROMPT

KW - RECALL

KW - SEEKING

KW - VALIDATION

KW - WEBSITE SATISFACTION

KW - Web-based tailoring

KW - aging

KW - anxiety

KW - audiovisual media

KW - cancer

KW - consultation

KW - health communication

KW - internet

KW - memory

KW - patient education

KW - patient participation

KW - patient reported outcomes

KW - randomized controlled trial

U2 - http://dx.doi.org/10.2196/14407

DO - http://dx.doi.org/10.2196/14407

M3 - Article

VL - 21

SP - e14407

JO - Journal of Medical Internet Research (JMIR)

JF - Journal of Medical Internet Research (JMIR)

SN - 1438-8871

IS - 10

M1 - 14407

ER -