Photo of Donna L. Berry,  PhD, RN, AOCN, FAAN

Donna L. Berry, PhD, RN, AOCN, FAAN

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 632-1909

Donna L. Berry, PhD, RN, AOCN, FAAN

Dana-Farber Cancer Institute


  • Associate Professor, Medicine, Harvard Medical School
  • Director, Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute


Research Abstract

OBJECTIVE: The purpose of this trial was to compare usual patient education plus the Internet-based, Personal Patient Profile-Prostate, versus usual education alone, on conflict associated with decision making, plus explore time-to-treatment and treatment choice.

METHODS: A randomized, multi-center clinical trial was conducted with measures at baseline, one and six months. Men with newly diagnosed localized prostate cancer who sought consultation at urology, radiation oncology or multi-disciplinary clinics in four geographically-distinct American cities were recruited. Intervention group participants used the Personal Patient Profile-Prostate, a decision support system comprised of customized text and video coaching regarding potential outcomes, influential factors, and communication with care providers. The primary outcome, patient-reported decisional conflict, was evaluated over time using Generalized Estimating Equations to fit generalized linear models. Additional outcomes, time-to-treatment, treatment choice and program acceptability/usefulness, were explored.

RESULTS: A total of 494 eligible men were randomized (266 intervention; 228 control). The intervention reduced adjusted decisional conflict over time as compared with the control group, for the uncertainty score (estimate -3.61; (confidence interval, -7.01,-0.22) and values clarity (estimate-3.57; confidence interval (-5.85,-1.30) Borderline effect was seen for the total decisional conflict score (estimate -1.75; confidence interval (-3.61,0.11). Time-to-treatment was comparable between groups, while undecided men in the intervention group chose brachytherapy more often than in the control group. Acceptability and usefulness were highly rated.

CONCLUSION: The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized prostate cancer. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a prostate cancer treatment that is consistent with the patient values and preferences.


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  • Trinh QD, Hong F, Halpenny B, Epstein M, Berry DL. Racial/ethnicity differences in endorsing influential factors for prostate cancer treatment choice: An analysis of data from the personal patient profile-prostate (P3P) I and II trials. Urol Oncol 2019. PubMed
  • Berry DL, Blonquist TM, Halpenny B, Hong F, Morrison-Ma SC, McCullough MC, Carelli K, Dominici LS, King TA. The Jacki Jacket after mastectomy with reconstruction: a randomized pilot study. Breast Cancer Res Treat 2019. PubMed
  • Lundquist DM, Berry DL. Experiences of Adolescents and Young Adults Living With Advanced Cancer: An Integrative Review. Oncol Nurs Forum 2019; 46:451-458. PubMed
  • Mohamed N, Leung TM, Shah QN, Pisipati S, Berry DL, Benn EKT, Lee CT, Hall S, Mehrazin R, Sfakianos J. Involving Patients in the Development and Evaluation of an Educational and Training Experiential Intervention (ETEI) to Improve Muscle Invasive Bladder Cancer Treatment Decision-making and Post-operative Self-care: a Mixed Methods Approach. J Cancer Educ 2019. PubMed
  • Knoerl R, Smith EML, Han A, Doe A, Scott K, Berry DL. Characterizing patient-clinician chemotherapy-induced peripheral neuropathy assessment and management communication approaches. Patient Educ Couns 2019. PubMed
  • Jabaley T, Underhill-Blazey ML, Berry DL. Development and Testing of a Decision Aid for Unaffected Women with a BRCA1 or BRCA2 Mutation. J Cancer Educ 2019. PubMed
  • Wilson LS, Blonquist TM, Hong F, Halpenny B, Wolpin S, Chang P, Filson CP, Master VA, Sanda MG, Chien GW, Jones RA, Krupski TL, Berry DL. Assigning value to preparation for prostate cancer decision making: a willingness to pay analysis. BMC Med Inform Decis Mak 2019; 19:6. PubMed
  • Pozzar RA, Berry DL. Preserving Oneself in the Face of Uncertainty: A Grounded Theory Study of Women With Ovarian Cancer. Oncol Nurs Forum 2019; 46:595-603. PubMed
  • Pozzar RA, Berry DL, Hong F. Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer. BMC Med Inform Decis Mak 2019; 19:124. PubMed
  • Lundquist DM, Berry DL, Boltz M, DeSanto-Madeya SA, Grace PJ. Wearing the Mask of Wellness: The Experience of Young Women Living With Advanced Breast Cancer. Oncol Nurs Forum 2019; 46:329-337. PubMed
  • Berry DL, Blonquist TM, Nayak MM, Grenon N, Momani TG, McCleary NJ. Self-Care Support for Patients with Gastrointestinal Cancer: iCancerHealth. Appl Clin Inform 2018; 9:833-840. PubMed
  • Berry DL, Blonquist TM, Pozzar R, Nayak MM. Understanding health decision making: An exploration of homophily. Soc Sci Med 2018; 214:118-124. PubMed
  • Cooley ME, Abrahm JL, Berry DL, Rabin MS, Braun IM, Paladino J, Nayak MM, Lobach DF. Algorithm-based decision support for symptom self-management among adults with Cancer: results of usability testing. BMC Med Inform Decis Mak 2018; 18:31. PubMed
  • Fadol AP, Mendoza TR, Lenihan DJ, Berry DL. Addressing the Symptom Management Gap in Patients With Cancer and Heart Failure Using the Interactive Voice Response System: A Pilot Study. J Adv Pract Oncol 2018; 9:201-214. PubMed
  • Sun M, Cole AP, Hanna N, Mucci LA, Berry DL, Basaria S, Ahern DK, Kibel AS, Choueiri TK, Trinh QD. Cognitive Impairment in Men with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. J Urol 2018. PubMed
  • Berry DL, Blonquist T, Nayak MM, Roper K, Hilton N, Lombard H, Hester A, Chiavacci A, Meyers S, McManus K. Cancer Anorexia and Cachexia: Screening in an Ambulatory Infusion Service and Nutrition Consultation
. 2018; 22:63-68. PubMed
  • Irwin MM, Dudley W, Northouse L, Berry DL, Mallory GA. Oncology Nurses' Knowledge, Confidence, and Practice in Addressing Caregiver Strain and Burden Oncol Nurs Forum 2018; 45:187-196. PubMed
  • Budhrani-Shani P, Chau NG, Berry DL. Psychosocial distress and the preferred method of delivery of mind-body interventions among patients with head-and-neck cancer. Patient Relat Outcome Meas 2018; 9:129-136. PubMed
  • Pozzar R, Baldwin LM, Goff BA, Berry DL. Patient, physician, and caregiver perspectives on ovarian cancer treatment decision making: lessons from a qualitative pilot study. Pilot Feasibility Stud 2018; 4:91. PubMed
  • Gilligan T, Coyle N, Frankel RM, Berry DL, Bohlke K, Epstein RM, Finlay E, Jackson VA, Lathan CS, Loprinzi CL, Nguyen LH, Seigel C, Baile WF. Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline. J Clin Oncol 2017. PubMed
  • Berry DL, Hong F, Blonquist TM, Halpenny B, Filson CP, Master VA, Sanda MG, Chang P, Chien GW, Jones RA, Krupski TL, Wolpin S, Wilson L, Hayes JH, Trinh QD, Sokoloff M, Somayaji P. Decision Support with the Personal Patient Profile-Prostate: A Multi-Center Randomized Trial. J Urol 2017. PubMed
  • Berry DL, Nayak MM, Abrahm JL, Braun I, Rabin MS, Cooley ME. Clinician perspectives on symptom and quality of life experiences of patients during cancer therapies: Implications for eHealth. 2017. PubMed
  • Cooley ME, Nayak MM, Abrahm JL, Braun IM, Rabin MS, Brzozowski J, Lathan C, Berry DL. Patient and caregiver perspectives on decision support for symptom and quality of life management during cancer treatment: Implications for eHealth. 2017. PubMed
  • Roper K, Siefert ML, Fuller F, Lucier D, Berry DL. Self-Administered Premedication: Improving Taxane Chemotherapy Treatment
. 2017; 21:234-239. PubMed
  • Pozzar RA, Berry DL. Gender Differences in Bladder Cancer Treatment Decision Making. Oncol Nurs Forum 2017; 44:204-209. PubMed
  • Momani TG, Berry DL. Integrative Therapeutic Approaches for the Management and Control of Nausea in Children Undergoing Cancer Treatment. J Pediatr Oncol Nurs 2017. PubMed
  • Mooney K, Berry DL, Whisenant M, Sjoberg D. Improving Cancer Care Through the Patient Experience: How to Use Patient-Reported Outcomes in Clinical Practice. Am Soc Clin Oncol Educ Book 2017; 37:695-704. PubMed
  • Pozzar RA, Berry DL. Patient-centered research priorities in ovarian cancer: A systematic review of potential determinants of guideline care. Gynecol Oncol 2017; 147:714-722. PubMed
  • Underhill ML, Hong F, Jones T, Sprunck-Harrild K, Walsh SK, Boyajian R, Berry DL, Partridge A. Feasibility and Acceptability of a Web Site to Promote Survivorship Care in Survivors of Hodgkin Disease. JCO Clin Cancer Inform 2019; 1:1-10. PubMed
  • Lobach DF, Johns EB, Halpenny B, Saunders TA, Brzozowski J, Del Fiol G, Berry DL, Braun IM, Finn K, Wolfe J, Abrahm JL, Cooley ME. Increasing Complexity in Rule-Based Clinical Decision Support: The Symptom Assessment and Management Intervention. JMIR Med Inform 2016; 4:e36. PubMed
  • Fann JR, Hong F, Halpenny B, Blonquist TM, Berry DL. Psychosocial outcomes of an electronic self-report assessment and self-care intervention for patients with cancer: a randomized controlled trial. 2016. PubMed
  • Tofthagen C, Kip KE, Passmore D, Loy I, Berry DL. Usability and Acceptability of a Web-Based Program for Chemotherapy-Induced Peripheral Neuropathy. Comput Inform Nurs 2016. PubMed
  • Wolpin S, Halpenny B, Sorrentino E, Stewart M, McReynolds J, Cvitkovic I, Chang P, Berry D. Usability Testing the "Personal Patient Profile-Prostate" in a Sample of African American and Hispanic Men. Comput Inform Nurs 2016. PubMed
  • Hong F, Blonquist TM, Halpenny B, Berry DL. Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment. Patient Relat Outcome Meas 2016; 7:127-35. PubMed
  • Budhrani-Shani P, Berry DL, Arcari P, Langevin H, Wayne PM. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review. Nurs Res Pract 2016; 2016:9018036. PubMed
  • LeBaron VT, Blonquist TM, Hong F, Halpenny B, Berry DL. Screening for Pain in the Ambulatory Cancer Setting: Is 0-10 Enough? J Oncol Pract 2015. PubMed
  • Morgans AK, van Bommel AC, Stowell C, Abrahm JL, Basch E, Bekelman JE, Berry DL, Bossi A, Davis ID, de Reijke TM, Denis LJ, Evans SM, Fleshner NE, George DJ, Kiefert J, Lin DW, Matthew AG, McDermott R, Payne H, Roos IA, Schrag D, Steuber T, Tombal B, van Basten JP, van der Hoeven JJ, Penson DF, . Development of a Standardized Set of Patient-centered Outcomes for Advanced Prostate Cancer: An International Effort for a Unified Approach. Eur Urol 2015. PubMed
  • Sheldon LK, Blonquist TM, Hilaire DM, Hong F, Berry DL. Patient cues and symptoms of psychosocial distress: what predicts assessment and treatment of distress by oncology clinicians? 2015. PubMed
  • Boucher J, Lucca J, Hooper C, Pedulla L, Berry DL. A Structured Nursing Intervention to Address Oral Chemotherapy Adherence in Patients With Non-Small Cell Lung Cancer. Oncol Nurs Forum 2015; 42:383-9. PubMed
  • Wolpin SE, Parks J, Galligan M, Russell KJ, Berry DL. Information Needs of Men with Localized Prostate Cancer During Radiation Therapy. J Cancer Educ 2015. PubMed
  • Underhill ML, Chicko L, Berry DL. A nurse-led evidence-based practice project to monitor and improve the management of chemotherapy-induced nausea and vomiting. 2015; 19:38-40. PubMed
  • Wu WW, Tsai SY, Liang SY, Liu CY, Jou ST, Berry DL. The Mediating Role of Resilience on Quality of Life and Cancer Symptom Distress in Adolescent Patients With Cancer. J Pediatr Oncol Nurs 2015. PubMed
  • Berry DL, Blonquist TM, Patel RA, Halpenny B, McReynolds J. Exposure to a patient-centered, Web-based intervention for managing cancer symptom and quality of life issues: impact on symptom distress. J Med Internet Res 2015; 17:e136. PubMed
  • Cooley ME, Blonquist TM, Catalano PJ, Lobach DF, Halpenny B, McCorkle R, Johns EB, Braun IM, Rabin MS, Mataoui FZ, Finn K, Berry DL, Abrahm JL. Feasibility of using algorithm-based clinical decision support for symptom assessment and management in lung cancer. J Pain Symptom Manage 2014. PubMed
  • Berry DL, Halpenny B, Bosco JL, Bruyere J, Sanda MG. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men. BMC Med Inform Decis Mak 2015; 15:56. PubMed
  • Berry DL, Blonquist TM, Hong F, Halpenny B, Partridge AH. Self-reported adherence to oral cancer therapy: relationships with symptom distress, depression, and personal characteristics. Patient Prefer Adherence 2015; 9:1587-92. PubMed
  • Underhill ML, Sheldon LK, Halpenny B, Berry DL. Communication about symptoms and quality of life issues in patients with cancer: provider perceptions. J Cancer Educ 2014. PubMed
  • Artherholt SB, Hong F, Berry DL, Fann JR. Risk factors for depression in patients undergoing hematopoietic cell transplantation. Biol Blood Marrow Transplant 2014. PubMed
  • Tariman JD, Doorenbos A, Schepp KG, Singhal S, Berry DL. Older adults newly diagnosed with symptomatic myeloma and treatment decision making. Oncol Nurs Forum 2014; 41:411-9. PubMed
  • Berry DL, Cunningham T, Eisenberg S, Wickline M, Hammer M, Berg C. Improving patient knowledge of discharge medications in an oncology setting. 2014; 18:35-7. PubMed
  • Berry DL, Hong F, Halpenny B, Partridge AH, Fann JR, Wolpin S, Lober WB, Bush NE, Parvathaneni U, Back AL, Amtmann D, Ford R. Electronic self-report assessment for cancer and self-care support: results of a multicenter randomized trial. J Clin Oncol 2014; 32:199-205. PubMed
  • Underhill ML, Hong F, Berry DL. When study site contributes to outcomes in a multi-center randomized trial: a secondary analysis of decisional conflict in men with localized prostate cancer. Health Qual Life Outcomes 2015; 12:159. PubMed
  • Tariman JD, Doorenbos A, Schepp KG, Singhal S, Berry DL. Information Needs Priorities in Patients Diagnosed With Cancer: A Systematic Review. J Adv Pract Oncol 2014; 2014:115-122. PubMed
  • Berry DL, Hong F, Halpenny B, Partridge A, Fox E, Fann JR, Wolpin S, Lober WB, Bush N, Parvathaneni U, Amtmann D, Ford R. The electronic self report assessment and intervention for cancer: promoting patient verbal reporting of symptom and quality of life issues in a randomized controlled trial. BMC Cancer 2014; 14:513. PubMed
  • Hussain M, Tangen CM, Berry DL, Higano CS, Crawford ED, Liu G, Wilding G, Prescott S, Kanaga Sundaram S, Small EJ, Dawson NA, Donnelly BJ, Venner PM, Vaishampayan UN, Schellhammer PF, Quinn DI, Raghavan D, Ely B, Moinpour CM, Vogelzang NJ, Thompson IM. Intermittent versus continuous androgen deprivation in prostate cancer. N Engl J Med 2013; 368:1314-25. PubMed
  • King SD, Fitchett G, Berry DL. Screening for religious/spiritual struggle in blood and marrow transplant patients. Support Care Cancer 2013. PubMed
  • McCleary NJ, Wigler D, Berry D, Sato K, Abrams T, Chan J, Enzinger P, Ng K, Wolpin B, Schrag D, Fuchs CS, Hurria A, Meyerhardt JA. Feasibility of computer-based self-administered cancer-specific geriatric assessment in older patients with gastrointestinal malignancy. Oncologist 2013; 18:64-72. PubMed
  • Sheldon LK, Kazmi M, Klein C, Berry DL. Concerns of stem cell transplant patients during routine ambulatory assessment. Patient Prefer Adherence 2013; 7:15-20. PubMed
  • Zhu J, Davis RB, Stuver SO, Berry DL, Block S, Weeks JC, Weingart SN. A longitudinal study of pain variability and its correlates in ambulatory patients with advanced stage cancer. Cancer 2012. PubMed
  • Berry DL, Wang Q, Halpenny B, Hong F. Decision preparation, satisfaction and regret in a multi-center sample of men with newly diagnosed localized prostate cancer. Patient Educ Couns 2012; 88:262-7. PubMed
  • Stuver SO, Isaac T, Weeks JC, Block S, Berry DL, Davis RB, Weingart SN. Factors associated with pain among ambulatory patients with cancer with advanced disease at a comprehensive cancer center. J Oncol Pract 2012; 8:e17-23. PubMed
  • Sommers RM, Miller K, Berry DL. Feasibility pilot on medication adherence and knowledge in ambulatory patients with gastrointestinal cancer. Oncol Nurs Forum 2012; 39:E373-9. PubMed
  • Weingart SN, Cleary A, Stuver SO, Lynch M, Brandoff D, Schaefer KG, Zhu J, Berry DL, Block S, Weeks JC. Assessing the quality of pain care in ambulatory patients with advanced stage cancer. J Pain Symptom Manage 2012; 43:1072-81. PubMed
  • Bosco JL, Halpenny B, Berry DL. Personal preferences and discordant prostate cancer treatment choice in an intervention trial of men newly diagnosed with localized prostate cancer. Health Qual Life Outcomes 2012; 10:123. PubMed
  • Berry DL, Blumenstein BA, Halpenny B, Wolpin S, Fann JR, Austin-Seymour M, Bush N, Karras BT, Lober WB, McCorkle R. Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 2011; 29:1029-35. PubMed
  • Wu WW, Johnson R, Schepp KG, Berry DL. Electronic self-report symptom and quality of life for adolescent patients with cancer: a feasibility study. Cancer Nurs 2011. PubMed
  • Potter P, Eisenberg S, Cain KC, Berry DL. Orange interventions for symptoms associated with dimethyl sulfoxide during stem cell reinfusions: a feasibility study. Cancer Nurs 2011. PubMed
  • Tariman JD, Berry DL, Halpenny B, Wolpin S, Schepp K. Validation and testing of the Acceptability E-scale for web-based patient-reported outcomes in cancer care. Appl Nurs Res 2011; 24:53-8. PubMed
  • Chan CW, Tam W, Cheng KK, Chui YY, So WK, Mok T, Wong C, McReynolds J, Berry DL. Piloting electronic self report symptom assessment - Cancer (ESRA-C) in Hong Kong: A mixed method approach. Eur J Oncol Nurs 2010. PubMed
  • Allen JD, Othus MK, Hart A, Tom L, Li Y, Berry D, Bowen D. A randomized trial of a computer-tailored decision aid to improve prostate cancer screening decisions: results from the take the wheel trial. Cancer Epidemiol Biomarkers Prev 2010; 19:2172-86. PubMed
  • Hammer MJ, Motzer SA, Voss JG, Berry DL. Glycemic Control Among Older Adult Hematopoietic Cell Transplant Recipients. 2010. PubMed
  • Berry DL, Halpenny B, Wolpin S, Davison BJ, Ellis WJ, Lober WB, McReynolds J, Wulff J. Development and evaluation of the personal patient profile-prostate (P3P), a Web-based decision support system for men newly diagnosed with localized prostate cancer. J Med Internet Res 2010; 12:e67. PubMed
  • Henrikson NB,Ellis WJ,Berry DL. "It's not like I can change my mind later": Reversibility and decision timing in prostate cancer treatment decision-making. Patient Educ Couns 2009; 77:302-7. PubMed
  • Fann JR,Berry DL,Wolpin S,Austin-Seymour M,Bush N,Halpenny B,Lober WB,McCorkle R. Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer. Psychooncology 2008; 18:14-22. PubMed
  • Wolpin S,Berry D,Austin-Seymour M,Bush N,Fann JR,Halpenny B,Lober WB,McCorkle R. Acceptability of an Electronic Self-Report Assessment Program for patients with cancer. Comput Inform Nurs 2008; 26:332-8. PubMed
  • Berry DL,Ellis WJ,Russell KJ,Blasko JC,Bush N,Blumenstein B,Lange PH. Factors that predict treatment choice and satisfaction with the decision in men with localized prostate cancer. Clin Genitourin Cancer 2007; 5:219-26. PubMed
  • Isaac T, Stuver SO, Davis RB, Block S, Weeks JC, Berry DL, Weingart SN. Incidence of severe pain in newly diagnosed ambulatory patients with stage IV cancer. Pain Res Manag 2012; 17:347-52. PubMed
  • Wolpin SE, Nguyen JK, Parks JJ, Lam AY, Morisky DE, Fernando L, Chu A, Berry DL. Redesigning pictographs for patients with low health literacy and establishing preliminary steps for delivery via smart phones. Pharm Pract (Granada) 2016; 14:686. PubMed
  • Reid Ponte P, Hayman LL, Berry DL, Cooley ME. A new model for postdoctoral training: the Nursing Postdoctoral Program in Cancer and Health Disparities. Nurs Outlook 2015; 63:189-203. PubMed