Qualitative Methods for Refining a Web-Based Educational Tool for Patients Focused on Inherited Cancer Predisposition

Applying the framework for developing and evaluating complex interventions to increase family communication about hereditary cancer

Objective

Evaluate an intervention to increase family communication (FC) of positive hereditary cancer test results using the Framework for Developing and Evaluating Complex Interventions (FDECI).

Methods

We developed 'programme theory' during the FDECI development phase by aligning intervention components with behavior change techniques (BCTs) and theoretical factors expected to improve FC. During the feasibility phase, we obtained feedback from 12 stakeholder interviews.

Results

Intervention components aligned with a total of 14 unique BCTs for which prior evidence links the BCT to theoretical factors that influence behavior change. Constructive stakeholder feedback included: more information desired, rewording to support autonomy by highlighting options, and improvements to navigation, visuals, and audio. Positive comments included: comprehensiveness of materials, modeling of conversations, and usefulness of the materials for helping a person prepare to share positive test results.

Conclusion

The first FDECI phases were helpful for improving the intervention and planning our ongoing effectiveness and future implementation phases.

Innovation

Our application of the FDECI is novel, including plans to test our 'programme theory' using coincidence analysis (CNA) to determine who accesses which intervention materials, how utilizing certain materials impact the aligned theoretical factors, and whether these in turn make a difference in the behavioral outcome.

Inherited Cancer Knowledge Among Black Females with Breast Cancer Before and After Viewing a Web-Based Educational Video

Purpose: Scalable solutions are needed to make pre-test genetic education about inherited cancer risk accessible across diverse and underserved populations. We evaluated an automated strategy to deliver genetic education through a web-based video among young Black females with breast cancer. Methods: 96 participants were recruited through state cancer registries in Florida and Tennesee. All participants viewed a 12 min video and completed a ten question quiz on inherited cancer knowledge before and after viewing the video. Median pre- and postvideo knowledge scores were categorized as <60% versus ≥60% and compared across demographic and clinical characteristics using binary logistic regression. Results: Of the 96 participants, mean age was 51, over 50% had income <$50 K, over 40% did not graduate college or have private insurance, and over 70% had previous genetic testing. Median knowledge scores significantly increased after viewing the video (p < 001), with no significant differences in those with or without prior testing. A higher post-video knowledge score was associated with an income ≥$50 K, a college degree, and private insurance (all p < .05). Conclusion: Among a population of young Black breast cancer patients, the educational video significantly increased knowledge. Findings support the use of automated pre-test educational tools as a scalable solution to make these services more accessible across populations.

Modeling Teacher Supports Toward Self-Directed Language Learning Beyond the Classroom: Technology Acceptance and Technological Self-Efficacy as Mediators

This study explored the contributions of teacher supports toward students' self-directed language learning beyond the classroom and investigated whether technology acceptance and technological self-efficacy could be the mediators between teacher supports and students' self-directed language learning in a sample of Chinese undergraduate students. A total of 197 freshmen students in one university in Eastern China participated in the questionnaires concerning teacher supports, technology acceptance, technological self-efficacy and self-directed language learning. The study highlighted the results: (1) perceived usefulness mediated the relationship between teacher affective supports and students' self-directed language learning as well as the relationship between teacher capacity supports and students' self-directed language learning; (2) technological self-efficacy mediated the relationship between teacher affective supports and students' self-directed language learning as well as the relationship between teacher behavior supports and students' self-directed language learning; and (3) perceived easy of use had no noticeable mediating functions, but exerted an indirect influence on students' self-directed language learning. These findings extended previous researches by considering both the external factors (i.e., teacher supports) and the internal factors (i.e., technology acceptance and technological self-efficacy) of influencing students' self-directed language learning, thereby contributing to enhancing our understanding of the joint drive of the inherent and extrinsic power mechanisms. This study indicated the significance of elevating teachers' awareness of the substantial supports in enhancing students' self-directed language learning beyond the classroom and would inform that the future research on teachers' compliance in relation to technology use be converted from institutional mandates into teachers' conscientious behaviors.