Evaluating a decision aid for breast cancer prevention: a pilot trial

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DESCRIPTION (provided by applicant): In the United States, breast cancer is the most common cancer among women and the leading cause of death in women between the ages of 45-60. The efficacy of prevention options such as chemoprevention and prophylactic surgery has been established. Yet breast cancer prevention remains underused, resulting in avoidable morbidity and mortality. The main barriers to effective use of breast cancer prevention are inaccurate perceptions of these interventions by patients and challenges to providers in identifying eligible patients. To address these barriers, our research will use a decision aid in the primary care setting to facilitate patient-centered and evidence-based breast cancer prevention. THE APPROACH: Building on our previous work, we will evaluate the clinical feasibility and efficacy of a decision aid for breast cancer prevention in the primary care setting. First, we will adapt our previously developed decision aid for use in the primary care setting. Second, we will conduct a randomized controlled trial to evaluate the effectiveness of two methods of delivery for the decision aid (use of the decision aid prior to the consultation, or during the consultation). THE INVESTIGATIVE TEAM AND ENVIRONMENT: The investigative team is highly interdisciplinary and brings together the necessary experience and expertise to accomplish the proposed research. Areas of expertise include: clinical research, clinical decision support methods, women's health, breast cancer prevention, and statistical analyses. The proposed team has developed and evaluated numerous decision support tools and methods making them uniquely suited and well-positioned to successfully complete the proposed research. THE POTENTIAL IMPACT: The goal of the proposed research is to further the science and application of informed decision making and patient-centered care in the context of breast cancer prevention. Our research will improve patient decisions about prevention by ensuring that their choices are aligned with current clinical knowledge and their own values. Targeting the primary care setting will enable the widespread identification of women who are likely to benefit from prevention interventions. By testing two methods of delivery for the decision aid, we aim to further the science of decision aid development and implementation. This work is ultimately expected to improve patient health outcomes and decrease the burden of breast cancer. PUBLIC HEALTH RELEVANCE: Significant advances in options for breast cancer prevention present an opportunity to reduce the incidence of this deadly disease. Yet breast cancer prevention remains underused, resulting in avoidable morbidity and mortality. Our research will use a decision aid in the primary care setting to facilitate the use of patient- centered and evidence-based breast cancer prevention.