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Picture of Breast Cancer: Your Decision Notebook®

Breast Cancer: Your Decision Notebook®

To order this product, contact:

Susan Brink, DrPH

HealthMark Multimedia

1201 Connecticut Ave, NW, Suite 250,
Washington, DC 20036

Phone: 202-265-0033 x 201

Fax: 202-728-0284

E-mail: sbrink@HealthMarkMultimedia.com

Company Web Site: www.HealthMarkMultimedia.com

Product Web Site: www.YourDecisionNotebook.com

Download PDF fileDownload a PDF of all the research components of this product.

Product Description

Product Description

Breast Cancer: Your Decision Notebook® offers evidence-based information about surgical, radiation, chemotherapeutic, and hormonal treatment options and reconstruction options to women who have been recently diagnosed with breast cancer. The product helps patients make decisions by offering interactive decision tools and personal stories from breast cancer survivors. Topics include effects of treatments on their lives, clarifying their own needs as well as the needs of their family, and generating questions for discussion with their physicians, nurses, or health counselors. Interactive questions, comparisons, and tips help guide the user through the decisions she faces.



Product Type


Who Is This Product For?

Women who are diagnosed with breast cancer and who are making decisions regarding their treatment plan

Where Is This Product Supposed to Be Used?

Women with breast cancer who are planning their treatment; health education programs at hospitals and breast centers

Other Information


Finalist for a FREDDIE award for quality multimedia products in women’s health

Winner of a Bronze Award for the 2004 HeSCA Media Fest

Peer-Reviewed Publications



  • NIH/NCI SBIR Product Showcase in September 2003
  • National Consortium of Breast Centers Annual Meeting, Las Vegas, Nevada, February 2004
  • APHA Annual Meeting, Washington, DC, November 2004

Press Releases


Organizations/Consortium Worked with During Project

Breast Center for Anne Arundel Medical Center

Commercial Collaborations/Actual Purchasers

HealthMark has initiated a two-part commercialization strategy with direct to consumer sales through www.yourdecisionnotebook.com and institutional sales with opportunities for institutional branding.

Patent, License, Trademark


Societal or Research Contribution/Success Story


Research Description

Grant Title

Choice Points: Breast Cancer Treatment CD-ROM

Grant Number


Abbreviated Abstract

Breast cancer will strike approximately one in eight American women over their life span, with 178,700 new cases anticipated in 1999. This Phase II SBIR will result in a multimedia CD-ROM, Breast Cancer: Your Decision Notebook®, that will help women make informed breast cancer treatment decisions. The product will focus on the personal aspects of the treatment, giving women an opportunity to consider non-medical needs during the treatment period, to learn how a suggested treatment will impact their lives, and to learn ways to manage these impacts. In Phase II, we will research and produce remaining informational content and graphic elements and concurrently identify and develop additional decision-support tools for the CD-ROM. The complete decision-support system will include information about breast cancer, its treatments, and the impact of those treatments, as well as tools for more effective information processing, treatment comparisons, treatment-related problem-solving, and clarification of treatment-related preferences and values. Product effectiveness in increasing women's confidence about their treatment decision will be field tested with recently diagnosed women.

Primary Investigator

Susan Brink, DrPH

About PI

As a Principal of HealthMark Multimedia, Dr. Brink is responsible for program design and development. Dr. Brink has been responsible for many aspects of project management, including recruitment and hiring of project personnel and consultants, research design, monitoring of field work, outcome and process evaluations, instrument development, analysis, and general project oversight. She has considerable experience in qualitative and quantitative evaluation of traditional and media-based health education products. Dr. Brink has been the PI on nine Small Business Innovation Research (SBIR) projects using multimedia technologies. These products have all been subjected to a rigorous process of identification of key messages and content; translation of messages and content into images, activities, and skills; and product testing.

Research Team & Affiliations

Susan Brink, DrPH, Principal Investigator

Ann McFarren, RN, Project Director

Jane Lincoln, MSW, Assistant Project Director

Amelia Birney, MPH, Instructional Designer

Jennifer Malone, Production Assistant

HealthMark Multimedia

Research Objectives


To research and produce remaining informational content and graphic elements for the CD-ROM.


To identify and develop additional decision-support tools for the CD-ROM.


To produce a complete decision-support system, Breast Cancer: Your Decision Notebook®, that includes information about breast cancer, its treatments, and the impact of those treatments, as well as tools for more effective information processing, patient-provider communication, treatment-related problem-solving, and clarification of treatment-related preferences and values.


To test the effectiveness of the CD-ROM to help recently diagnosed women with early-stage breast cancer learn about the various treatment options, feel confident participating in treatment decisions, and feel satisfied with the decisions.


Compared to women receiving readily available and accepted print material about breast cancer, women who use the CD-ROM will:

Demonstrate increased knowledge about (1) the treatment procedures and (2) side effects of treatments.

Report increased self-efficacy in communicating their treatment-related values and preferences to their health care providers.

Report increased self-efficacy in their ability to integrate their personal needs and their treatment needs.

Report increased self-efficacy in participating with their physician(s) on treatment decisions.

Report increased self-efficacy in comparing options and making a personal treatment decision.

Report increased satisfaction with their treatment decisions.

Experimental Design

The effectiveness of the CD-ROM was tested against an alternate source of breast cancer knowledge with a randomized controlled trial. After pretest, women were given either the CD-ROM or Dr. Susan Love’s Breast Book. There was a posttest at the conclusion of the study period.

Final Sample Size & Study Demographics

Twenty-two women who had been diagnosed with breast cancer and who had not yet made a final surgical decision

Data Collection Methods

Written pretest and posttest questionnaires

Outcome Measures

Knowledge, self-efficacy, decision satisfaction

Evaluation Methods

Change scores were compared for the experimental and control groups.

Research Results

There was no difference posttest intervention on knowledge, self-efficacy, or decisional satisfaction. Each group did make similar significant pre- to postintervention changes in knowledge and self-efficacy.

Information on CD-ROM and book usage indicates that similar proportions of women in each group used the material in the same manner. There were also no differences between groups on issues related to patient involvement in their care, such as comparing treatment options, identifying questions, communicating options, considering their involvement in the decision, or making a decision that they were comfortable with.

Barriers & Solutions


Total Budget


Products Developed from This Research