A Multimedia Application of the PACE Framework: Development and Preliminary Testing of a Cancer Survivor-Provider Communication Training Program

Although there is strong evidence that effective patient-provider communication is associated with better patient satisfaction and quality of life, the design and evaluation of programs designed to educate patients about how to communicate effectively with their providers has received little research attention. Embedded in a comprehensive web-based program for breast cancer patients completing medical treatment, we developed a PACE multimedia communication program (Presenting, Asking, Checking, Expressing) to teach survivors how to improve communication with their physicians through strategic planning and preparation. Web-based multimedia application was used to provide instruction in communication techniques, an interactive question prompt list, survivorship care planning information, and a role modeling video. The iterative development process included: 1) evidence-based content development and vetting; 2) user testing; and 3) usability testing. User testing (n = 12 women) validated the concept of the program and role modeling video. The program front page and the design layout were improved based on users' feedback. Usability testing (n = 7 women) additionally identified several navigational difficulties of the interactive features and improved the program functionality. Preliminary intervention study web usage data from 158 breast cancer patients enrolled in a randomized, controlled intervention trial showed that 60% of the participants had accessed the PACE survivorship communication program during their first web visit, 32% of them had reviewed the PACE training materials and role modeling video, and 40% of the participants had used the interactive question prompt list to review potential questions about survivorship to pose to their health care providers. The iterative development process, including user and usability testing, was informative in identifying gaps and survivors' preferences, which were used to enhance the relevance of the program. Preliminary web usage results demonstrate the acceptability and potential of such a program for breast cancer survivors.