An Escape Room Intervention to Help Improve Breast Cancer Patients' Ability to Navigate Online Access to Nutrition Information

Not Applicable

Completed

Conditions: Anatomic Stage I Breast Cancer AJCC v8
Anatomic Stage II Breast Cancer AJCC v8
Anatomic Stage III Breast Cancer AJCC v8

Interventions: Other: Educational Intervention
Other: Interview
Other: Survey Administration
Other: Telemedicine

Registration Number: NCT06193070

Lead Sponsor: Fred Hutchinson Cancer Center

Brief Summary: This clinical trial evaluates an educational escape room intervention for improving awareness of and concern about breast cancer misinformation and reducing vulnerability to believing cancer misinformation among patients with stage I-III breast cancer. Misinformation, or communication about health information that is inaccurate or false, can have serious health consequences for those that believe it. The rise of the access to and use of various sources of information on the internet such as websites and social media has caused the spread of misinformation and disinformation to grow rapidly, resulting in negative consequences on health outcomes. Cancer misinformation, in particular, has become an increasingly prevalent issue that poses a real threat to the many cancer patients in the United States. The educational escape room intervention is a game designed to teach participants how to discern whether cancer nutrition information is accurate or may potentially be misinformation. Participants are immersed in the narrative while solving puzzles to learn key themes such as the need to talk to their doctors, looking for scientific studies, as well as avoiding fads and trends, miracle cures, anecdotal evidence, and targeted and clickbait ads.

Detailed Description: OUTLINE:

Patients complete a baseline before playing the virtual cancer nutrition information escape room game. Patients then play the virtual misinformation escape room game consisting of 5 puzzles and a final task over 30-45 minutes on study. Following the escape room game, patients complete a post-game survey and debrief interview (15 minutes).

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 45

Inclusion Criteria

Age 18 years of age or older
English speaking
Able to provide informed consent
Have access to a computer (desktop or laptop)
Have been previously diagnosed with breast cancer (Stages I-III) and currently in active treatment for breast cancer

Exclusion Criteria

Not provided

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Supportive Care (escape room game)	Telemedicine	Patients play the virtual misinformation escape room game consisting of 5 puzzles and a final task over 30-45 minutes on study.
Supportive Care (escape room game)	Educational Intervention	Patients play the virtual misinformation escape room game consisting of 5 puzzles and a final task over 30-45 minutes on study.
Supportive Care (escape room game)	Interview	Patients play the virtual misinformation escape room game consisting of 5 puzzles and a final task over 30-45 minutes on study.
Supportive Care (escape room game)	Survey Administration	Patients play the virtual misinformation escape room game consisting of 5 puzzles and a final task over 30-45 minutes on study.

Primary Outcome Measures

Name	Time	Method
Percentage of Participants Accrued to the Study (Feasibility)	At enrollment	The percentage of patients who accrue to the study among those who are eligible and approached.
Percentage of Patients Who Complete Game Sessions (Feasibility)	Up to 1 week	The percentage of patients who complete the game.
Satisfaction (Acceptability)	Up to 1 week	Will be assessed using a Likert-type question to assess satisfaction with the game (1 = not at all satisfied, 10 = very satisfied)
Likelihood to Recommend the Game to Someone Else (Acceptability)	Up to 1 week	Will be assessed using a Likert-type question to assess likelihood to recommend the game to someone else (1 = not at all likely, 5 = very likely).
Usability (System Usability Scale)	Up to 1 week	Usability will be assessed using the System Usability Scale (SUS). The SUS is a reliable, 10-item measure 10-item scale, scored on a 5-point Likert scale (1=strongly disagree; 5=strongly agree), with previously reported excellent internal reliability (Cronbach's α = 0.91). Total scores on the SUS range from 0-100, with higher scores indicating greater usability.

Secondary Outcome Measures

Name	Time	Method
Types of Online Information	At baseline	Will be assessed using a 6-item checklist that asks which resources participants or their family members have used to find nutrition information in the past 3 months (self-care/health and wellness book, telephone advice service, booklet/flyer shared by a health professional, internet forums, internet search, social media). Reported as count data of number of participants who endorsed one or more sources (self-care/health and wellness book, telephone advice service, booklet/flyer shared by a health professional, internet forums, internet search, social media).
Concern About Misinformation and Confidence in Identifying Misinformation	Up to 1 week	Will be assessed using our 4-item scale in which patients indicate degree to which they agree with statements using a 5-point Likert scale (1=strongly disagree, 5=strongly agree). Items asked participants to rate the degree to which they agree with the following: (1) I am more worried about accidentally believing misinformation, (2) I am more worried about accidentally sharing misinformation online, (3) I am more concerned about misinformation in society, and (4) I feel more confident in my ability to identify misinformation).
Cancer Nutrition Information Beliefs	At baseline and up to 1 week	Will be assessed using a 15-item checklist of common cancer nutrition misinformation and credible nutrition advice, using a 5-point Likert Scale (1=definitely false, 5 = definitely true). Data reported as an average score at both pre-intervention (pre-game score) and post-intervention (post-game score).