Increasing readiness to decide and strengthening behavioural intentions: evaluating the impact of a web-based patient decision aid for breast cancer treatment options

Objectives To undertake a quantitative evaluation of a theory-based, interactive online decisionaid (BresDex) to support women choosing surgery for early breastcancer (Stage I and II), based on observations of its use in practice. Methods Observational cohort study. Website log-files collected data on the use of BresDex. Online questionnaires assessed knowledge about breastcancer and treatmentoptions, degree to which women were deliberating about their options, and surgery intentions, pre- and post-BresDex. Results Readiness to make adecision significantly increased after using BresDex (p < .001), although there was no significant improvement in knowledge. Participants that were ‘less ready’ to make adecision before using BresDex, spent a longer time using BresDex (p < .05). Significant associations between surgery intentions and choices were observed (p < .001), with the majority of participants going on to have BCS. Greater length of time spent on BresDex was associated with stronger intentions to have BCS (p < .05). Conclusion The use of BresDex appears to facilitate readiness to make adecision for surgery, helping to strengthen surgery intentions.