8
Methods
CHESS
This study was conducted based on the discussion group transcripts of The
Comprehensive Health Enhancement Support System (CHESS), a networked computer-
based system for patients with breast cancer. CHESS provides multiple supportive
services for these patients, including an asynchronous bulletin board-style discussion
group, as well as various sources of information, access to medical advice, and
decision-making tools. Discussion groups account for the majority of uses of the system,
and women report that their participation has been highly valuable to them. Individuals
participating in the discussion group can address messages or parts of messages to
specific individuals, but everyone has the privilege to read all messages (Gustafson et
al., 1998, McTavish et al., 1995).
Subject population
Data was obtained from a study of newly diagnosed breast cancer patients
recruited from 5 medical facilities in Madison, WI, Chicago IL, and Indianapolis, IN.
Eligible patients were those up to 60 years of age (n= 246) and half of the women were
randomized to the CHESS intervention (n=121). The study was limited to those patients
randomized to the computer intervention who wrote at least one message that was not a
test of the system (n = 82). Independent variables were obtained from archived text
transcripts from the discussion group forums. Although participants were enrolled on the
study for 26 weeks, only the first two months of participation were considered in this
analysis since both the acute period of psychological adjustment to breast cancer
(Spiegel, 1997) and the majority of the reported positive effects CHESS (Gustafson et
al., 2001) occur within this time frame.
Convention