. Author manuscript; available in PMC: 2018 Jan 8.

Published in final edited form as: Cancer Nurs. 2013 Sep-Oct;36(5):355–367. doi: 10.1097/NCC.0b013e31827910ba

Table 1.

Overview of Components of Interactive Decision Aid for Adolescents

“DecisionKEYS for Balancing Choices” [Formerly, “Choices for Tomorrow: Decision Making as a Life Tool”]
Learning Objectives and Reinforcement Strategies: By the end of the reinforcement component of the program, adolescents will: (1) acquire an understanding of not only the “how to” (procedures) but also the “why” (outcomes) of quality decision making; (2) recognize the need for quality decision making for consequential decisions faced by adolescents, especially for personal health concerns and lifestyle behaviors of smoking, alcohol consumption, and illicit drug use; (3) apply an easy recall method – the theory of better decision making – to understand and evaluate their own decision making and that of others; (4) prepare “Right for Me” choices as a part of self-care; and (5) use quality decision making as a life tool to enhance their early and late quality of life. Teaching/learning strategies include: (1) repetition, with standardization of content by CD-ROMs; (2) memory aids in the workbook to break down the parts of the decision-making process; (3) practice in the context of adolescence; (4) application to real world problems (risk behaviors) of the adolescent; and (5) multimodal approaches to content at a variety of times for reinforcement.
1. Decision-Making Module ©: A 17-minute video (now CD-ROM) on decision making will be used to teach a quality process to the teen. This module also includes a short curriculum for the healthcare professional. The intent of this live-action, color video is to teach an easy-recall method for making lifestyle and other health-related decisions. This method includes the basics of a psychological theory, the Janis and Mann (1977) conflict model of decision making, which has successfully been taught to teen survivors and their healthy peers in the Hollen’s previous studies. A cameo spot in the video includes an introduction by one of the theorists, Dr. Leon Mann, University of Melbourne, Australia. Characteristics of the video, depicting 17 decisions (including engaging in smoking as well as alcohol and street drug use), include cultural diversity within the illustrations and live actors, diverse positive role models, appealing musical score, and digital video effects to stimulate interest. A special feature that appeals to teens is the illustrated and easy-to-remember names for five decision-making styles. Several other highlights of the module that were adapted from Janis and Mann are the balance sheet procedure for evaluating the pros and cons of a risky decision and 7 points for grading decision making. The workbook includes key components of the decision theory, such as the decision-making styles with their illustrations, as well as the balance sheets (self-checking technique) for practice during home assignment. This module has been developed/tested by the PI. Shown in full at initial visit and as booster. Script reading level = 7^th grade level, using Flesh-Kincaid readability index. 2. Smoking Module: An 11-minute, award-winning video for grades 7–12 will be used to provide insight into why some teens start smoking and why it’s so hard for them to stop. This live-action, color video, “Smoking: The Burning Truth” from Sunburst, a Houghton Mifflin Company, uses teen interviews to drive home the message of health consequences to smoking behavior. Facts are presented, such as the effect of nicotine on the body organs, and that those most likely to smoke are those whose parents smoke or friends smoke. Converted to CD-ROM. 3. Alcohol/Drug Use Module: A 10-minute portion (2 vignettes) from an award-winning video for grades 7–12 will provide meaningful adolescent context for alcohol use, the most prevalent risk behavior for teens. A live-action, color video, “Teens, Drugs, and Peer Pressure” from Sunburst, provides insight into the consequences of party drinking on interpersonal relationships as well as shows role playing of refusal strategies for drugs by two teens. Portion shown at initial visit; shown in full (18 min.) as booster. Converted to CD-ROM. 4. Interactive Substance Use Module: A 30–60 minute researched-based, interactive CD-ROM for grades 7–12 provides practice in deciding how to handle difficult situations with substance use, such as alcohol and marijuana. This module, “On the Road” from Will interactive, Inc., enables students to make choices about drug use by “playing it out before they live it out” and discover for themselves that good decisions result in good outcomes, while poor ones can lead to disaster. Teens can take as much time as they like, choose as many different paths as they like (or repeat) in the comfort of own home or library. 5. Health Status Module: A 15-minute face-to-face, tailored discussion with the health professional that includes using the Risk Behavior Facts Sheet ©, developed by Hollen, Hobbie, and Hudson (2006), and helping the teen to identify “Right for Me” (RFM) choices that consider one’s past medical history. The concept of RFM choices was coined to support teens with special needs in responding comfortably with pre-chosen responses when pressured by peers. Estimated at 7^th grade reading level.

“DecisionKEYS for Balancing Choices” [Formerly, “Choices for Tomorrow: Decision Making as a Life Tool”]

Learning Objectives and Reinforcement Strategies: By the end of the reinforcement component of the program, adolescents will: (1) acquire an understanding of not only the “how to” (procedures) but also the “why” (outcomes) of quality decision making; (2) recognize the need for quality decision making for consequential decisions faced by adolescents, especially for personal health concerns and lifestyle behaviors of smoking, alcohol consumption, and illicit drug use; (3) apply an easy recall method – the theory of better decision making – to understand and evaluate their own decision making and that of others; (4) prepare “Right for Me” choices as a part of self-care; and (5) use quality decision making as a life tool to enhance their early and late quality of life. Teaching/learning strategies include: (1) repetition, with standardization of content by CD-ROMs; (2) memory aids in the workbook to break down the parts of the decision-making process; (3) practice in the context of adolescence; (4) application to real world problems (risk behaviors) of the adolescent; and (5) multimodal approaches to content at a variety of times for reinforcement.

1. Decision-Making Module ©: A 17-minute video (now CD-ROM) on decision making will be used to teach a quality process to the teen. This module also includes a short curriculum for the healthcare professional. The intent of this live-action, color video is to teach an easy-recall method for making lifestyle and other health-related decisions. This method includes the basics of a psychological theory, the Janis and Mann (1977) conflict model of decision making, which has successfully been taught to teen survivors and their healthy peers in the Hollen’s previous studies. A cameo spot in the video includes an introduction by one of the theorists, Dr. Leon Mann, University of Melbourne, Australia. Characteristics of the video, depicting 17 decisions (including engaging in smoking as well as alcohol and street drug use), include cultural diversity within the illustrations and live actors, diverse positive role models, appealing musical score, and digital video effects to stimulate interest. A special feature that appeals to teens is the illustrated and easy-to-remember names for five decision-making styles. Several other highlights of the module that were adapted from Janis and Mann are the balance sheet procedure for evaluating the pros and cons of a risky decision and 7 points for grading decision making. The workbook includes key components of the decision theory, such as the decision-making styles with their illustrations, as well as the balance sheets (self-checking technique) for practice during home assignment. This module has been developed/tested by the PI. Shown in full at initial visit and as booster. Script reading level = 7^th grade level, using Flesh-Kincaid readability index.
2. Smoking Module: An 11-minute, award-winning video for grades 7–12 will be used to provide insight into why some teens start smoking and why it’s so hard for them to stop. This live-action, color video, “Smoking: The Burning Truth” from Sunburst, a Houghton Mifflin Company, uses teen interviews to drive home the message of health consequences to smoking behavior. Facts are presented, such as the effect of nicotine on the body organs, and that those most likely to smoke are those whose parents smoke or friends smoke. Converted to CD-ROM.
3. Alcohol/Drug Use Module: A 10-minute portion (2 vignettes) from an award-winning video for grades 7–12 will provide meaningful adolescent context for alcohol use, the most prevalent risk behavior for teens. A live-action, color video, “Teens, Drugs, and Peer Pressure” from Sunburst, provides insight into the consequences of party drinking on interpersonal relationships as well as shows role playing of refusal strategies for drugs by two teens. Portion shown at initial visit; shown in full (18 min.) as booster. Converted to CD-ROM.
4. Interactive Substance Use Module: A 30–60 minute researched-based, interactive CD-ROM for grades 7–12 provides practice in deciding how to handle difficult situations with substance use, such as alcohol and marijuana. This module, “On the Road” from Will interactive, Inc., enables students to make choices about drug use by “playing it out before they live it out” and discover for themselves that good decisions result in good outcomes, while poor ones can lead to disaster. Teens can take as much time as they like, choose as many different paths as they like (or repeat) in the comfort of own home or library.
5. Health Status Module: A 15-minute face-to-face, tailored discussion with the health professional that includes using the Risk Behavior Facts Sheet ©, developed by Hollen, Hobbie, and Hudson (2006), and helping the teen to identify “Right for Me” (RFM) choices that consider one’s past medical history. The concept of RFM choices was coined to support teens with special needs in responding comfortably with pre-chosen responses when pressured by peers. Estimated at 7^th grade reading level.