To ensure full participation and cooperation, we offered a self-directed education intervention to women randomized to the control condition. To control for the effect of education, the educational materials were also offered to the women randomized to the treatment condition. Thus, all participants were offered educational materials after baseline testing and after each follow-up session. They were given a list of materials to select from and to take home on loan. The selection of 30 books, 15 pamphlets, 5 videotapes, and 7 audiotapes covered a wide range of topics related to breast cancer, including medical information, coping with adverse effects of chemotherapy and radiation, pain control, lymphedema, menopause, nutrition, breast self-examination, body image, sexuality, emotional coping, social support, shared personal experiences, photography, poetry, artwork, humor, politics and history of breast cancer, chronic illness, inspiration, spirituality, hospice, and death. They were also given a 1-year membership to a consumer health library in their community. At each follow-up visit, participants were asked if they had used the educational materials. Thirty-two control patients and 35 treatment patients answered yes to this question at least once. Control patients answered yes a total of 57 times (range, 1-4 times each). Treatment patients answered yes on 64 occasions (range, 1-5 times each).