Health Care Partners in Cancer Prevention & Care of Aged

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DESCRIPTION (provided by applicant): To better understand factors influencing cancer prevention and cancer care among elderly persons; we propose a five-year longitudinal study to test a "Health Care Partnership" (HCP) model of doctor-patient health communication. We consider not only doctor-patient communication, but also proactive roles played by consumers and their family members in information gathering and communication concerning health. We examine how communication among health care partners influences use of preventive practices concerning colorectal, breast, prostate, and skin cancers. For respondents diagnosed with cancer, we also explore how communication with doctors and caregivers influences quality of life outcomes. We place health communication in an ecological context (Kreps, 2002) by considering structural and personal influences on health care partnerships. We will conduct four annual face-to-face interviews with two representative community samples of elderly participants in our prior research (N=900). Telephone interviews will be conducted with physicians and informal health care partners of our elderly respondents to assess their orientations to communication about cancer prevention and care. We will use both autoregressive and latent growth curve structural equation models (SEM) to assess potential transitory and developmental processes in our HCP model of health communication. In addition to using these quantitative approaches to gain insights about factors facilitating cancer prevention and care among the aged, we also propose in-depth qualitative interviews with older adults who have been diagnosed with cancer and with their HSOs. Through use of these multiple methods, we hope to develop insights that may inform interventions with elderly consumers, with health significant others, and with physicians to enhance communication skills that may benefit patient care and elderly persons' quality-of-life outcomes.