300 women recently diagnosed with breast cancer were randomly assigned to three arms: 1) usual care plus a book or audio tape about breast cancer, 2) a computer for five months with access to and training on using Internet plus URLs for good breast cancer sites, 3) a computer, access to and training on the web-based CHESS breast cancer program web offering 17 breast cancer services and links to other Internet sites. Semi-final results: Women in the Internet arm used Internet about the same amount as the CHESS women but quickly moved from health sites to non-health topics. A pretest plus 2 and 5 month posttests found no differences between control group and internet arms on the eight quality of life outcomes studied. The CHESS arm improved over the control group on six of eight quality of life outcomes. This study raises concerns about whether giving patients URLs of good websites (even with training on using the internet) will improve outcomes. The most important advantage of CHESS may be its closed, guided universe of information, skills training and support options; an integrated package where everything points to everything else, instead of requiring search and discovery of many web sites.

Learning Objectives:

• Describe how women recently diagnosed with breast cancer actually use the internet
• Describe how those women differ from a usual care control group in terms of quality of life outcomes
• Describe how women given access to a comprehensive system of information, skills training and support improved on quality of life