Implementing a Low-Literacy, Multimedia Information Technology System to Enhance Patient-Centered Cancer Care

Using technology to promote better patient understanding of their cancer and treatment may improve communication, adherence to treatment, and outcomes. It may also improve patient satisfaction, knowledge, self-efficacy, treatment, and health-related quality of life (HRQL). In particular, technology in the form of a multimedia information and assessment system targeted to individuals with low literacy is hoped to enhance patient-centered care and improve outcomes when used in daily clinic al practice.    

This project evaluated such a system, called the CancerHelp® Talking Touchscreen (TT), targeted to patients being treated for breast and colorectal cancer. The system collected patient self-reported data and provided patient education on diagnoses, treatment, support, side effects, prevention, and screening.

The specific aims of this project were to:          

• Test whether a low-literacy-friendly multimedia information and assessment information technology system used in daily clinical practice improves patient outcomes during treatment in 200 recently diagnosed breast and colorectal cancer patients based on the primary endpoints: satisfaction with health care communication, knowledge of cancer and treatment, self-efficacy, adherence to recommended treatment, and HRQL.
• Evaluate the relationships between patient characteristics, resources, needs, health behaviors, and health outcomes using the Behavioral Model for Vulnerable Populations.
• Test whether use of the multimedia information technology system improves adherence to recommended post-treatment surveillance care and HRQL during the early post-treatment surveillance period (3 months after treatment).        

Patients with Stage I-to-III breast or colorectal cancer receiving chemotherapy and/or radiation therapy were randomized to one of two arms: the CancerHelp-TT intervention or control, stratified by the clinic they attended. A total of 129 patients participated; 65 in the intervention arm and 64 in the control arm. 

The study found no statistically significant difference between the groups in satisfaction with communication, HRQL, health beliefs, or cancer knowledge. It was noted that there was a consistent trend in improvements in the tracked endpoints in the intervention group versus the control group. Health literacy was moderately associated with better HRQL, higher cancer knowledge, and more adaptive health beliefs. Overall, participants rated the CancerHelp-TT software favorably.