The goal of this Developmental Project is to address the needs of breast cancer survivors in transition - as they migrate out of cancer care and into primary care.

Research questions to be addressed include the following:

• Is "pushing" tailored information to cancer survivors after completion of multimodality therapy effective? Examples of information that would be pushed would be tailored reminders about aerobic and weight-bearing exercise, low fat diet strategies, surveillance imaging, and medical appointments.
• What are effective "pull" strategies for women who have completed breast cancer who have information needs, symptoms, and concerns about recurrence? For example, can an interactive cognitive-behavioral program reduce concerns about recurrence? What formats are most effective for breast cancer survivors?
• Are interactive, algorithm-driven self-management programs feasible and effective in women experiencing common side effects of breast cancer treatment, such as hot flashes?
• Can web-based support improve satisfaction with information, vitality, and quality of life?
• Can web-based support reduce unnecessary medical visits?
• Are medical providers, including primary care providers, satisfied with tailored web-based support as a model of care?

Patients will have completed surgery, chemotherapy, trastuzumab (which is given for a year after surgery), and radiation therapy and will have started adjuvant hormonal therapy if indicated.

This intervention is for patients completing multimodality breast cancer treatment as a novel model of care for breast cancer survivors. The intervention, which will include a dedicated "transition visit" and tailored web-based support, will be designed to provide informational support and strategies for self-management of long-term effects of cancer and its treatment after completion of multimodality breast cancer treatment.

The transition visit will (1) provide a treatment summary and survivorship care plan as recommended by the American Society of Clinical Oncology, (2) develop appropriate strategies and referrals to address treatment sequelae, (3) promote self-management of treatment side effects and health promotion skills, including coordination of care with the multispecialty team of cancer providers, and (4) promote physical, psychological, social, and spiritual well being.

The visit, which will be with the treating nurse practitioner, will last approximately 90 minutes. The treatment summary and survivorship care plan will be developed before the visit and will be provided to the treating physicians for any revisions. Before the visit, patients will complete a number of on-line instruments in order to assess such characteristics as current symptoms and concerns, health literacy, and information-seeking style. During the visit, the patient will also be introduced to a personalized web page. The web-based component of the intervention will be designed during the proposed research period.

study in progress

study in progress

study in progress