The FYI on MRI: A Multilevel Decision Support Intervention for Screening Breast MRI

MRI 仅供参考：用于筛查乳腺 MRI 的多级决策支持干预措施

基本信息

批准号：
10591106
负责人：
Claire C Conley
金额：
$ 19.43万
依托单位：
GEORGETOWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-05 至 2028-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10591106
关键词：
Address Age American Cancer Society American College of Radiology Awareness Behavioral Biopsy Black race Breast Breast Cancer Detection Breast Cancer Risk Assessment Tool Breast Cancer Risk Factor Breast Magnetic Resonance Imaging Cancer Burden Cancer Etiology Capital Caring Cessation of life Clinic Clinical Communities Community Clinical Oncology Program Complement Comprehensive Cancer Center Conflict (Psychology)Data Decision Aid Decision Making Development Diagnosis Disparity District of Columbia Early identification Effectiveness of Interventions Environment Epidemiologist Future Goals Guidelines High Risk Woman Individual International Intervention Interview K-Series Research Career Programs Knowledge Latina Magnetic Resonance Imaging Mammographic screening Mammography Medical Mentors Mentorship Modality National Breast and Cervical Cancer Early Detection Program National Comprehensive Cancer Network National Institute on Minority Health and Health Disparities Not Hispanic or Latino Nurse Practitioners Oncologist Participant Patient Preferences Patient-Centered Care Patients Persons Population Population Heterogeneity Positioning Attribute Protocols documentation Race Randomized Recommendation Research Research Support Risk Risk Assessment Scientist Screening for cancer Site System Testing Training Training Programs Translating United States Preventative Services Task Force Woman Work black women cancer diagnosis cancer risk career community engaged research community setting cost cultural values effectiveness testing experience high risk intervention effect lifetime risk malignant breast neoplasm patient level intervention patient navigation patient navigator post intervention preference prevent primary outcome programs randomized trial risk prediction model satisfaction screening screening guidelines secondary outcome skills treatment as usual

项目摘要

PROJECT SUMMARY The proposed K08 career development award will provide Dr. Conley with the training and mentorship necessary to become an independent clinical scientist focused on leveraging multilevel approaches to support informed decision making about risk-based cancer screening in diverse populations. She has identified decision-making about screening breast MRI among high-risk Black and Latina women as a critical issue to address in order to achieve this goal. This proposal describes a 5-year comprehensive program of training and mentored research for an academic career at the intersection of medical decision making and risk-based cancer screening. This K08 will provide key training in community engaged research, medical decision making, multilevel interventions, and cancer risk prediction models. The intensive research experience provided by the K08 aims will provide the opportunity to implement and practice the skills gained through the training goals. The primary objective of the proposed research is to develop and test a multilevel intervention to support informed decision making about screening breast MRI among high-risk Black and Latina women. Women at high risk for breast cancer (i.e., ≥20% lifetime risk) can decide to supplement mammography screening with MRI or continue with mammography alone. Some women will benefit from screening with breast MRI, though some will experience harms due to the higher rate of biopsies, false-positive results, and higher costs. Thus, informed decision making about screening breast MRI is critical for high-risk women. An informed decision is defined as a decision that is made with sufficient knowledge, and is in line with the person’s preferences. To make informed decisions about screening breast MRI, high-risk women must: (1) be identified as high risk; (2) be made aware that breast MRI is an option; (3) understand MRI’s benefits and drawbacks; and (4) make a decision aligned with their preferences. However, lack of awareness and access may prevent high-risk Black and Latina women from making an informed decision about breast MRI. The study’s specific aims are: (1) develop and deliver a universal breast cancer risk assess- ment protocol in a community setting; (2) develop a culturally-relevant decision aid with input from diverse stake- holders; and (3) assess the effect of the multilevel decision support intervention (i.e., risk assessment + decision aid) on informed decisions about breast MRI. Dr. Conley’s mentorship team – including world-renowned behav- ioral scientists, clinical trialists, breast oncologists, epidemiologists, and biostatisticians – will provide guidance to support her research aims and complement her didactic training. These factors, in addition to the supportive research environment at Georgetown Lombardi Comprehensive Cancer Center, will enable her to achieve the proposed project aims. The proposed study will provide pilot data for a future R01 application to test the effec- tiveness of this intervention in the NCI Community Oncology Research Program. Dr. Conley will also possess the skills and experience to leverage multilevel approaches to support informed decision-making about risk- based cancer screening in diverse populations. This will result in sustained and impactful scientific contributions.

项目摘要拟议的K08职业发展奖将为Conley博士提供必要的培训和心态成为一名专注于利用多级方法来支持知情的临床科学家关于潜水员种群中基于风险的癌症筛查的决策。她已经确定了决策关于在高风险黑人和拉丁裔妇女中筛查乳房MRI，这是要解决的关键问题实现这一目标。该提案描述了一项为期5年的培训和修改研究的综合计划在医疗决策和基于风险的癌症筛查的交汇处的学术生涯。这 K08将提供社区参与研究，医疗决策，多层次干预措施的关键培训，和癌症风险预测模型。 K08 AIMS提供的密集研究经验将为通过培训目标实施和练习获得的技能的机会。的主要目标拟议的研究是开发和测试多层次干预措施，以支持有关知情的决策在高风险的黑人和拉丁女性中筛选乳房MRI。乳腺癌高风险的妇女（即≥20％终生风险）可以决定使用MRI补充乳房X线摄影筛查，或仅继续进行乳房X线摄影。有些女性将从乳房MRI的筛查中受益，尽管由于较高，有些女性会遭受危害活检率，假阳性结果和更高的成本。那是关于筛查乳房的明智的决策 MRI对于高风险女性至关重要。明智的决定定义为以足够的决定做出的决定知识，并且符合该人的喜好。做出有关筛查乳房的明智决定 MRI，高风险妇女必须：（1）被确定为高风险；（2）注意乳房MRI是一种选择；（3）了解MRI的好处和缺点；（4）决定与他们的偏好保持一致。然而，缺乏意识和访问可能会阻止高风险的黑人和拉丁裔妇女做出明智的决定关于乳房MRI。该研究的具体目的是：（1）开发和提供普遍的乳腺癌风险评估 - 社区环境中的指定协议；（2）通过潜水员利益的投入来发展与文化相关的决策辅助持有人；（3）评估多层次决策支持干预措施的影响（即风险评估 +决策援助）关于乳房MRI的明智决定。康利博士的Mentalship团队 - 包括世界知名的行为 - Ioral科学家，临床试验者，乳房肿瘤学家，流行病学家和生物统计学家将提供指导支持她的研究目标并补充她的教学培训。这些因素，除了支持性乔治敦伦巴第综合癌症中心的研究环境将使她能够实现拟议的项目目标。拟议的研究将为未来的R01应用提供试验数据，以测试效率这项干预对NCI社区肿瘤研究计划的影响。康利博士也将拥有利用多级方法来支持有关风险的明智决策的技能和经验 - 在潜水员种群中基于癌症筛查。这将导致持续且有影响力的科学贡献。