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

• 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
• 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

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K 08职业发展奖将为康利博士提供必要的培训和指导 成为一名独立的临床科学家，专注于利用多层次的方法来支持知情的 在不同人群中进行基于风险的癌症筛查。她认为决策 关于在高风险黑人和拉丁裔妇女中筛查乳房MRI是一个需要解决的关键问题， 实现这一目标。该提案描述了一个为期5年的培训和指导研究的综合计划 在医疗决策和基于风险的癌症筛查的交叉点的学术生涯。这 K 08将提供社区参与研究，医疗决策，多层次干预， 和癌症风险预测模型。K 08 aims提供的深入研究经验将为 有机会实施和实践通过培训目标获得的技能。的主要目的 拟议的研究是开发和测试一种多层次的干预，以支持知情决策， 在高风险黑人和拉丁裔妇女中筛查乳房MRI。乳腺癌高危女性（即，≥20% 终身风险）可以决定用MRI补充乳房X光检查筛查或继续单独进行乳房X光检查。 一些妇女将受益于乳房MRI筛查，尽管有些妇女会因较高的乳腺癌风险而受到伤害。 活检率、假阳性结果和更高的成本。因此，有关乳腺癌筛查的知情决策 MRI对高危女性至关重要。一个明智的决定被定义为一个决定，是充分 知识，并符合人的喜好。对乳腺癌筛查做出明智的决定 MRI，高风险女性必须：（1）被确定为高风险;（2）意识到乳房MRI是一种选择;（3） 了解MRI的优点和缺点;（4）根据他们的偏好做出决定。然而，在这方面， 缺乏认识和接触可能会阻止高风险黑人和拉丁妇女做出知情决定 关于乳房核磁共振成像该研究的具体目标是：（1）开发和提供通用的乳腺癌风险评估- （2）制定一个与文化相关的决策辅助工具，并从不同的利益相关者那里获得投入， 持有者;以及（3）评估多级决策支持干预的效果（即，风险评估+决策 援助）关于乳房MRI的知情决定。康利博士的导师团队包括世界知名的 口腔科学家、临床试验专家、乳腺肿瘤学家、流行病学家和生物统计学家将提供指导 以支持她的研究目标，并补充她的教学训练。这些因素，除了支持 乔治敦隆巴迪综合癌症中心的研究环境，将使她能够实现 提出项目目标。拟议的研究将为未来的R 01应用提供试点数据，以测试其效果。 NCI社区肿瘤学研究计划中的这种干预措施。康利博士还将拥有 利用多层次方法支持有关风险的知情决策的技能和经验- 在不同人群中进行癌症筛查。这将带来持续和有影响力的科学贡献。