Abstract B31: Implementation of video improves understanding of breast cancer concepts in an undereducated county hospital population
Authors: Shirah Gina R. , Bouton Marcia E. , Nodora Jesse , Hsu Chiu-Hsieh , Klemens Anne E. , Martinez Maria Elena , Komenaka Ian K. 
Published: December 2010

Abstract
Purpose of Study: Having accurate knowledge of the risks and benefits of treatment options is critical to informed decision making. Increasing knowledge of patients improves their ability to participate in decision making. Patients of all backgrounds diagnosed with breast cancer must determine an appropriate treatment plan and therefore must possess a general understanding of the concepts related to systemic therapy, radiation therapy, and surgery. The purpose of this study was to evaluate how well patients at a county hospital, who were prepared to undergo their definitive breast cancer operation, understood basic concepts of their disease and treatment.
Experimental Procedures: An 11 question multiple choice tool was devised at a Flesch-Kincaid grade level of 5.8. The questions were designed to evaluate the patients’ basic understanding of the significance of a cancer diagnosis, and use of mammography, chemotherapy, radiation therapy, and surgery. A previous study was performed as an initial assessment to obtain baseline information on patients’ understanding. 41 consecutive patients were evaluated at Maricopa Medical Center, the county, safety net hospital in Phoenix, Arizona. Subsequently an eight minute video was designed to facilitate the understanding of these basic breast cancer concepts. The next 40 consecutive patients who saw the video were then administered the same 11 question tool.
Data Summary: Eighty-one women agreed to participate in the study, 41 before and 40 after the implementation of a breast cancer educational video. Sixty-eight percent self identified as Hispanic and 51% had less than a high school education. Clinical presentation, stage of disease, and tumor biology was similar in both groups. The group of patients who saw the video answered each question correctly more often and had a higher mean number of total questions answered correctly (6.7 vs. 8.9, p = 0.0007). For the three questions (number 1, 6, 9) which the first group answered correctly less than 50% of the time, the video group correctly answered the three questions correctly 68%, 80%, and 68% of the time (p &lt; 0.05). Interestingly 90% of all respondents correctly answered the question on the value of screening mammography, however, only 37% of these patients underwent screening mammograms. Univariate analysis of the first 41 patients, who did not see the video, demonstrated that employment, years of education, and language of questionnaire (English vs. Spanish) was associated with higher score on the 11 question tool. When patients who saw the video were included and seeing the video (yes vs. no) was added to the analysis, univariate analysis revealed that years of education (p &lt; 0.0001), language of the questionnaire (p = 0.0004), and having seen the video (p = 0.0005) were significantly correlated with higher score. A multiple linear regression model adjusting for years of education, language, and seeing the video, revealed that having seen the video (p = 0.0029) and years of education (p = 0.0002) remained significantly associated with higher score.
Conclusion: Implementation of a short eight minute educational video significantly improved understanding of breast cancer concepts in an undereducated, county hospital population. This examination revealed, however, continuing deficits in the understanding of breast cancer concepts in this population.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B31.