Entertainment education for breast cancer surgery decisions: a randomized trial among patients with low health literacy

Abstract

Objective: To evaluate an entertainment-based patient decision aid for early stage breast cancer surgery in low health literacy patients.

Methods: Newly diagnosed female patients with early stage breast cancer from two public hospitals were randomized to receive an entertainment-based decision aid for breast cancer treatment along with usual care (intervention arm) or to receive usual care only (control arm). Pre-decision (baseline), pre-surgery, and 1-year follow-up assessments were conducted.

Results: Patients assigned to the intervention arm of the study were more likely than the controls to choose mastectomy rather than breast-conserving surgery; however, they appeared better informed and clearer about their surgical options than women assigned to the control group. No differences in satisfaction with the surgical decision or the decision-making process were observed between the patients who viewed the intervention and those assigned to the control group.

Conclusions: Entertainment education may be a desirable strategy for informing lower health literate women about breast cancer surgery options.

Practice implications: Incorporating patient decision aids, particularly computer-based decision aids, into standard clinical practice remains a challenge; however, patients may be directed to view programs at home or at public locations (e.g., libraries, community centers).