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Project Connect Online: Improving Psychosocial Adjustment for Women with Breast Cancer with an Internet-Based Intervention


OBJECTIVE: Emotional expression and receipt of social support can promote psychological and physical health in women diagnosed with breast cancer. Communication between breast cancer patients and their social network can be challenging, however. Study 1 of the current research aimed to characterize the experience of women who participated in the intervention arm of Project Connect Online (PCO), a randomized controlled trial for breast cancer patients to create personal websites to facilitate emotional expression and communication with supportive others. Study 2, a comparative effectiveness trial of PCO for women with metastatic breast cancer (MBC), examined the potential psychosocial and physical health-related benefits of sharing personal websites with other MBC patients, family, and friends (PCO PLUS condition) versus sharing with family and friends only (PCO ONLY condition).

METHODS: Study 1 examined the 46 women in the intervention arm of PCO, a three-hour workshop for creation of personal websites with a journal function. Participants completed assessments at baseline, one month, and six months. In Study 2, 30 women with MBC were randomly assigned to PCO PLUS (n = 14) or PCO ONLY (n = 16) and attended a similar workshop. General and cancer-specific psychosocial and physical functioning was assessed at baseline, two months, and four months. Multilevel models examined comparative effectiveness of the two conditions, potential mediating variables, and predictors of change in outcomes.

RESULTS: Women in Study 1 found the websites useful for telling the story of their experience and expressing emotions. Greater use of positive and negative emotion words on the websites was associated with improved psychological functioning at six months. Women with advanced cancer were more likely to use their websites than women with early-stage disease. In Study 2, significant increases in life appreciation, MBC-related altruism, and cancer-related physical symptoms and worsening physical functioning were observed across conditions. Anxiety decreased significantly in PCO PLUS and did not change in PCO ONLY. No significant mediated effects of PCO PLUS versus PCO ONLY on outcomes were observed.

CONCLUSIONS: Personal websites can help women with breast cancer, and, in particular, MBC, construct a narrative of their experience and receive support. For women with MBC, personal websites to communicate with family and friends may improve cancer-specific psychosocial adjustment. Communicating with other MBC patients via personal websites, even infrequently, may confer additional psychosocial benefits.

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