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. 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). In this 1-year repeated-measures randomized controlled trial, 325 breast and prostate cancer patients were randomized into 1 experimental group with access to WebChoice and 1 control group who received URLs of publicly available cancer Web sites. 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. This randomized 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. 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.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

An AHA Science Advisory recommending that physicians intervene more assertively to get patients to adopt healthier lifestyles, directly targeting smoking, obesity, poor diet, and physical inactivity

Precision health considers individual lifestyle, genetics, behaviors, and environment context and facilitates interventions aimed at helping individuals achieve well-being and optimal health. To present the Nursing Science Precision Health (NSPH) Model and describe the integration of precision health concepts within the domains of symptom and self-management science as reflected in the National Institute of Nursing Research P30 Centers of Excellence and P20 Exploratory Centers. Center members developed the NSPH Model and the manuscript based on presentations and discussions at the annual NINR Center Directors Meeting and in follow-up telephone meetings. The NSPH Model comprises four precision components (measurement; characterization of phenotype including lifestyle and environment; characterization of genotype and other biomarkers; and intervention target discovery, design, and delivery) that are underpinned by an information and data science infrastructure. Nurse scientist leadership is necessary to realize the vision of precision health as reflected in the NSPH Model.

Current theories of human health behaviors suggest that clients' preferences for specific aspects of a health regimen are an important influence on their decisions to initiate and continue use of the regimen. Despite low rates of participation in cardiac rehabilitation programs, especially among women, little research has been done to determine patient preferences for features of cardiac rehabilitation programs. The purpose of this study was to identify and compare women's and men's preferences for specific cardiac rehabilitation program features. Using a descriptive survey design, a convenience sample of 65 individuals (33 men and 32 women) participating in a cardiac rehabilitation program completed a self-administered survey in which they indicated both the importance of each of 17 cardiac rehabilitation program features and the extent to which they had experienced each of the features. Convenience factors (drive time, transportation, noninterference with other life activities, and ease of learning the exercises) were well-met preferences for both women and men. Men's and women's preferences were not well met for being able to discuss their progress with professionals and the ability to choose their own exercises. Men indicated that the ability to set their own goals was their greatest unmet preference. Women's preferences for not having pain and not tiring while exercising were significantly less well met than those of men. These findings suggest that a cardiac rehabilitation program that is responsive to client preferences should emphasize joint goal setting with participants and discussion of progress, offer frequent encouragement from professionals, and provide a range of exercise choices. Attention to women's concerns about pain and fatigue while exercising should also be addressed in the program.