Evaluating participants' use of a hormone replacement therapy decision-making intervention

Background: Associations between optimal use of a tailored decision-aid and levels of accuracy of perceived breast cancer risk, confidence in decision-making, and satisfaction with decisions about HRT were evaluated in a randomized intervention trial with a community sample of women aged 45-54. Methods: Data are from 289 women randomized to receive a computer-tailored three-step decision-aid. Results: Forty-seven percent of participants reported optimal use of the intervention materials. African American women and those with low confidence in decision-making were less likely to use the intervention optimally than white women and those with higher confidence (P < 0.05). Optimal use of the decision-aid was associated with increased accuracy of perceived risk and confidence to make a decision. Discussion: When used optimally, self-directed decision-aids can improve women's ability to make decisions about HRT. Additional refinement of these aids is needed. For some subgroups of women, adjuncts such as telephone counseling also might be considered. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.