A Two-Stage Model for Colorectal Cancer Screening

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This KO2 Research Career Award application outlines a 3-year plan for combining research, education and teaching for development of a career in health services research with a cancer-prevention and control orientation. Recently, the importance of health services, outcomes research and physician-patient decision-making have all been highlighted at the national level as necessary and understudied areas for preventive oncology research [1,2]. The career development and research plan proposed in this application are designed to begin establishing the candidate as an independent investigator in health services research and cancer prevention and control. Prior work by the candidate [3] provides the methodological basis for the proposed study's overall hypothesis: that use of colorectal cancer screening services is a two-stage process, consisting of appropriate physician recommendations and subsequent compliance by patients. A preliminary study by the candidate [4] and work in progress supply the initial data needed to practically test this hypothesis. The-phased plan is designed to provide the remainder of necessary information of investigator the processes underlying receipt of cancer prevention services; focusing specifically on how to improve physician recommendations and communication of CRC screening, and how to reduce patient barriers and facilitate patient decision-making for CRC screening. This proposal advances current knowledge about cancer screening through an exploration of the health services and behavioral issues that influence physician and patient decision-making. Although the results of this proposed study will have relevance for achieving the best outcomes in colorectal cancer screening, the framework may also be tested and applied in other areas of preventive health care. The career development portion of this grant application is intended to both compliment and supplement the research plan, which together will shape the candidate's career as an independent investigator in health services research with a prevention perspective.