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The Impact of Provider Social Networks on Breast Cancer Screening

提供者社交网络对乳腺癌筛查的影响

基本信息

批准号：
9188042
负责人：
Sarah A Nowak
金额：
$ 15.49万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-01 至 2018-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9188042
关键词：
Adoption Advisory Committees Affect Age Area Back Behavior Benefits and Risks Breast Cancer Detection Breast Cancer Early Detection Breast Cancer Model Breast Cancer Patient Clinical Conflict (Psychology)Decision Making Development Diagnosis Diffusion of Innovation Early Diagnosis Family Family member Feedback Foundations Friends Grant Guidelines Health behavior Individual Information Networks Internet Intervention Knowledge Learning Legal patent Malignant Neoplasms Mammographic screening Mammography Medical Modeling Network-based Patient Care Patients Perception Physicians Population Preventive Preventive service Provider Reaction Recommendation Screening for cancer Shapes Social Network Surveys Testing Translating Update Woman base behavioral outcome breast cancer diagnosis cancer diagnosis clinical practice epidemiology study evidence base experience malignant breast neoplasm mathematical methods member models and simulation mortality novel older women peer public health relevance randomized trial risk perception screening success therapy design

项目摘要

DESCRIPTION (provided by applicant): In the US, guidelines that seek to reduce cancer screening among certain patients often fail to impact clinical practice. Physician's social networks-the web of relationships among individuals-have been shown to be an important factor in the diffusion of innovation and may also be critical in settings where guidelines may conflict and where some guidelines may seek to roll-back, or de-implement, clinical practice. The objective of this exploratory R21 grant is to characterize how information from physicians' social networks defined as their colleagues, friends, and family members along with experiences from their own clinical practice may alter perceptions and recommendations regarding breast cancer screening and how this information affects population rates of screening. In Aim 1, we will conduct a national survey of physicians to characterize the extent to which their breast cancer screening recommendations are influenced by their experiences with medical colleagues, knowledge of friends and family who have been diagnosed with breast cancer, and encounters with their patients. In Aim 2, we will use the results of the survey to incorporate physicians into our existing agent-based model of patients' breast cancer screening decisions. The resulting model will allow study of interactions between physicians and patients, capturing the resulting feedback loops. Using this model, we will simulate different interventions by altering how social networks influence patient and provider decision making. With network interventions being increasingly deployed and the evidence base for cancer screening continuing to evolve, the proposed project will help prioritize aspects of interventions that may have the greatest likelihood of success in changing clinical practice.

描述（由申请人提供）：在美国，寻求减少某些患者癌症筛查的指南往往无法影响临床实践。医生的社交网络——个人之间的关系网络——已被证明是创新传播的一个重要因素，并且在指南可能发生冲突以及某些指南可能寻求倒退或取消临床实践的环境中也可能至关重要。这项探索性 R21 拨款的目的是描述来自医生社交网络（定义为同事、朋友和家人）的信息以及他们自己的临床实践经验如何可能改变有关乳腺癌筛查的看法和建议，以及这些信息如何影响人群的筛查率。在目标 1 中，我们将对医生进行一项全国性调查，以确定他们的乳腺癌筛查建议在多大程度上受到他们与医疗同事的经历、对被诊断患有乳腺癌的朋友和家人的了解以及与患者的接触的影响程度。在目标 2 中，我们将利用调查结果将医生纳入我们现有的基于代理的患者乳腺癌筛查决策模型中。由此产生的模型将允许研究医生和患者之间的相互作用，捕获由此产生的反馈循环。使用这个模型，我们将通过改变社交网络影响患者和提供者决策的方式来模拟不同的干预措施。随着网络干预措施的不断部署和癌症筛查证据基础的不断发展，拟议的项目将有助于优先考虑最有可能成功改变临床实践的干预措施的各个方面。