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Improving cancer screening in older adults with limited life expectancy

改善预期寿命有限的老年人的癌症筛查

基本信息

批准号：
10161680
负责人：
Nancy Schoenborn
金额：
$ 24.3万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-15 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10161680
关键词：
Address Age Area Breast Cancer Detection Clinical Practice Guideline Clinical Treatment Clinical Trials Clinical Trials Design Colorectal Colorectal Cancer Communication Coupled Data Decision Aid Decision Making Development Development Plans Elderly Elements Environment Feedback Fostering Funding Goals Grant Harm Reduction Health Status Intervention Interview Intuition Leadership Learning Life Expectancy Malignant Neoplasms Malignant neoplasm of prostate Mentors Morbidity - disease rate Patients Pattern Physicians Preventive care Primary Health Care Process Publications Qualitative Methods Randomized Controlled Trials Recommendation Reporting Research Research Methodology Research Personnel Research Proposals Resources Scholarship Screening for Prostate Cancer Screening for cancer Structure Surveys Testing Time United States National Institutes of Health Visit Work acceptability and feasibility base career career development experience feasibility testing follow-up implementation science improved indexing innovation leadership development malignant breast neoplasm mortality multi-component intervention novel overtreatment patient oriented patient screening point of care primary outcome provider behavior routine screening screening screening guidelines skills therapy development tool

项目摘要

PROJECT SUMMARY Background: Cancer screening can lower cancer-related mortality and morbidity but may be associated with significant harms and burdens in older adults. There is often a lag-time of 10 years before patients screened for breast, colorectal, or prostate cancers actually benefit. On the other hand, multiple harms from screening can occur in the short-term. Older adults with limited life expectancy continue to receive cancer screening at high rates even though it exposes them to the harms of screening with little chance of benefit. Clinicians are a major driver of over-screening but why they often continue to recommend cancer screening in older adults with limited life expectancy is unknown. This proposal aims to improve the cancer screening of older adults by 1) identifying the factors that facilitate or hinder clinician recommendations to stop routine screening in older adults with limited life expectancy, and 2) better supporting clinicians to appropriately incorporate life expectancy in their screening recommendations. Research proposal: Aim 1 will use qualitative methods to understand the range of factors that facilitate or hinder clinicians from recommending screening cessation in older adults with limited life expectancy. Aim 2 will test these factors in a national physician survey to determine and quantify their effects on physicians' screening recommendations in older adults with limited life expectancy. Aim 3 will then develop and pilot test a novel multi-modal intervention to target the factors that significantly contribute to over-screening. The intervention will be developed with input from clinicians and older adults and will use multiple, overlapping strategies that may include decision support, communication coaching, and clinician feedback. Career development plan: The candidate is a geriatrician who has already demonstrated national and institutional leadership in research and a strong track record of academic scholarship with numerous high impact publications and early investigator grants. Her long-term career goal is to be a research leader focused on incorporating life expectancy to inform patient-centered, individualized preventive care decisions for older adults. She has laid out a comprehensive, feasible career development plan that will enable her to transition into an independent investigator and research leader. She proposes to learn new skills in decision support, clinical trial design, and implementation science, in addition to continued development of leadership skills. She has assembled an exemplary mentoring team with expertise in the subject area and the relevant research methods and works in a rich research environment with tremendous resources to support her development. Summary: The proposal addresses an important research gap and produces a novel intervention that may have major impact to improve the cancer screening of older adults. The results from this proposal will support a subsequent large-scale clinical trial to test the intervention. This proposal will also further foster the career development of the candidate into a research leader focused on individualized preventive care in older adults.

项目总结

项目成果

期刊论文数量（26）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Patient Perceptions of Diabetes Guideline Frameworks for Individualizing Glycemic Targets.

患者对个体化血糖目标的糖尿病指南框架的看法。

DOI：
10.1001/jamainternmed.2019.3806
发表时间：
2019
期刊：
JAMA internal medicine
影响因子：
39
作者：
Schoenborn,NancyL;Crossnohere,NorahL;Bridges,JohnFP;Pollack,CraigE;Pilla,ScottJ;Boyd,CynthiaM
通讯作者：
Boyd,CynthiaM

Different Types of Patient Health Information Associated With Physician Decision-making Regarding Cancer Screening Cessation for Older Adults.

与医生关于老年人停止癌症筛查的决策相关的不同类型的患者健康信息。

DOI：
10.1001/jamanetworkopen.2023.13367
发表时间：
2023
期刊：
JAMA network open
影响因子：
13.8
作者：
Schoenborn,NancyL;Boyd,CynthiaM;Pollack,CraigE
通讯作者：
Pollack,CraigE

A Novel Curriculum on Using Life Expectancy to Inform Cancer Screening in Older Adults.

DOI：
10.1111/jgs.17016
发表时间：
2021-02
期刊：
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
影响因子：
6.3
作者：
Ahmed, Shaista U.;Burke, Meg;McGuire, Maura;Massare, Jacqueline;Boyd, Cynthia M.;Pollack, Craig E.;Lentz, Caroline;Schoenborn, Nancy L.
通讯作者：
Schoenborn, Nancy L.

Physician Decision-Making About Surveillance in Older Adults With Prior Adenomas: Results From a National Survey.

医生对患有腺瘤的老年人进行监测的决策：全国调查的结果。

DOI：
10.14309/ajg.0000000000002193
发表时间：
2023
期刊：
The American journal of gastroenterology
影响因子：
0
作者：
Schoenborn,NancyL;Pollack,CraigE;Gupta,Samir;Boyd,CynthiaM
通讯作者：
Boyd,CynthiaM

Association between Breast Cancer Screening Intention and Behavior in the Context of Screening Cessation in Older Women.

DOI：
10.1177/0272989x20979108
发表时间：
2021-03
期刊：
Medical decision making : an international journal of the Society for Medical Decision Making
影响因子：
0
作者：
Schoenborn NL;Pinheiro A;Kistler CE;Schonberg MA
通讯作者：
Schonberg MA