Internet Searching Behaviors of Low Literacy Breast Cancer Survivors

Internet searching is a popular tool for patients to find health-related information. However, low literacy individuals are at a disadvantage with respect to their ability to evaluate online health information. When using common web search engines to find health information, behaviors such as misspelling, misappropriation of words and incomplete search queries can result in inadequate results and misleading information. The goal of this research is to understand the search strategies and common mistakes that low-literacy Latina breast cancer survivors exhibit when searching for information online in order to inform future information seeking interfaces. To explore search behaviors online we asked survivors of breast cancer to search specific information about their condition on the web using either written or voice search. We also invited their caregivers as they often provide support for them. We video-taped their activity and analyzed the strategies they used to find information using a coding scheme developed for this task. We found that participants spent considerably more time evaluating the results lists rather than reading the information on any individual result. We also found that participants frequently read aloud as a comprehension strategy. We also surveyed the caregivers who, seemed to know less about breast cancer than the actual survivors. This study should be considered preliminary as we only have analyzed the activities of five women, however, there is a strong indication that low-literacy patients may not be understanding all they read on the internet and, moreover, result sets seem to overwhelm them. Lastly, it is possible that their caregivers are not able to help guide them either

Are You Convinced? A Wizard of Oz Study to Test Emotional vs. Rational Persuasion Strategies in Dialogues

This research explores ideal methods of persuasion through computer-mediated dialogue. We attempt to identify which persuasive strategy is most successful. We designed a Wizard of Oz laboratory experiment, where participants interact with a human wizard via a custom-developed web-based chat interface. The wizard attempted to persuade participants to learn more about Tai Chi using the following persuasive strategies: Emotional Positive, Emotional Negative, Rational Positive, and Rational Negative. Based on the results of the pre- and post-chat questionnaire, participants’ interest in learning Tai Chi was significantly greater after completing the dialogue and 69% percent of the participants printed a flyer to receive more information. Furthermore, conversations using the Emotional Positive strategies resulted in more successful persuasion than rational ones. The results of our study suggest that Emotional Positive strategies may be the most effective. We also suggest successful strategies as a design guideline for autonomous dialogue systems for persuasion

Study Design and Protocol for My Guide: An e-Health Intervention to Improve Patient-Centered Outcomes Among Hispanic Breast Cancer Survivors

Breast cancer is the most commonly diagnosed non-skin cancer in women and the leading cause of death among Hispanic women living in the United States. Relative to non-Hispanic white women, Hispanic women report poorer health related quality of life (HRQoL) after treatment. Although eHealth interventions delivered via Smartphones are a viable approach to addressing supportive care accessibility issues while also integrating multidisciplinary approaches for improving HRQoL, few eHealth interventions have been developed that specifically target Hispanic breast cancer survivors (BCS). This manuscript describes the methodology of a multisite, randomized controlled behavioral trial investigating the feasibility and preliminary efficacy of a Smartphone application aimed at improving HRQoL and cancer-specific distress among Hispanic BCS. Participants will be randomized to receive the intervention application, My Guide (psychoeducation & self-management program), or the health education control condition application, My Health (health education), for six weeks. All participants will also receive weekly telecoaching to enhance adherence to both control and intervention conditions. We will measure the study’s primary outcomes, general and disease-specific HRQoL and cancer-specific distress, at three time points: prior to, immediately after the intervention, and eight weeks after initial application use. My Guide may have the potential to improve HRQoL, and to address issues of limited access to supportive care among Hispanic women recovering from breast cancer treatment

Designing an mHealth Application to Bridge Health Disparities in Latina Breast Cancer Survivors: A Community-Supported Design Approach

Latina breast cancer patients in the USA report significantly worse cancer-related symptom burden and health-related quality of life than non-Hispanic whites. However, health literacy (e.g. knowledge about cancer, coping skills and communication) has been found to improve quality of life. In this paper, we present a case study of the methodology used to design Mi Guía (My Guide), a mobile application that aims to improve symptom burden and health-related quality of life among Hispanic women who have completed active treatment for breast cancer by increasing their health literacy. We developed a community-supported approach to building the application, which involved: (1) eliciting feedback from community leaders such as support group organizers and facilitators who are bilingual in Spanish and English, prioritize patients’ preferences and best interests and have a unique knowledge of the women and their needs; (2) conducting a formal evaluation of design principles based on previous interaction design research and user responses; (3) incorporating feedback from potential future users. In this paper, we discuss our methodology, and the challenges and benefits of this approach. We believe that future studies that aim to develop mobile technologies for underserved populations may benefit from a community-supported approach to design