Grant Details
| Grant Number: | 5R01CA112379-04 Interpret this number |
| Primary Investigator: | Elston Lafata, Jennifer |
| Organization: | Henry Ford Health System |
| Project Title: | Physician Recommendation and Colorectal Cancer Screening |
| Fiscal Year: | 2009 |
Abstract
DESCRIPTION (provided by applicant): Data from our own efforts and those of others indicate that different physicians discuss different things when recommending cancer screening. The U.S. Preventive Services Task Force (USPSTF) while not endorsing a specific style of physician-patient interaction, recently advocated for the use of shared decision-making when making preventive service recommendations to individual patients. We propose to use a mixed-method approach that includes both qualitative and quantitative data collection and analyses to understand the use and utility of different aspects of shared decision-making when physicians recommend CRC screening in primary care. First, we will use direct observation and audio-recording of routine health maintenance visits (n=900) to characterize the nature and content of CRC screening discussions in primary care (Aim 1). Results from these qualitative efforts will be used to derive quantitative measures characterizing physician-patient discussions of CRC screening in primary care. In the second stage, we will join these qualitatively derived measures characterizing physician-patient discussions of CRC screening with automated claims/laboratory data to determine their relationship to 12-month post-visit CRC screening use (Aim 2). A combined pre- and post-visit patient survey will allow us to assess the concordance of patient preferences for screening modality, information, and participation in decision-making with what occurs in the observed visit. We will then be able to evaluate the effect of these concordances on 12-month post-visit CRC screening use (Aim 3). We will use the Henry Ford Health System (HFHS), a large integrated delivery system serving Detroit and its surrounding suburbs, as the setting for these efforts. The diversity and size of the HFHS primary care physician and patient populations combined with the comprehensive, existing automated data systems makes this an ideal environment in which to conduct the proposed work. By joining detailed accounts of the contribution of both physicians and patients to CRC screening discussions in the real world of primary care with subsequent CRC screening use and patient reported preferences, results from the proposed project will inform a new generation of interventions aimed at improving CRC screening participation. They will provide valuable information for training both physicians and patients how to effectively discuss CRC screening as well as facilitate the development of decision aides and policies for diverse populations.
Publications
Patients with mental health needs are engaged in asking questions, but physicians' responses vary.
Authors: Tai-Seale M, Foo PK, Stults CD
Source: Health Aff (Millwood), 2013 Feb;32(2), p. 259-67.
PMID: 23381518
Related Citations
Grant Numbers:
| NCI NIH HHS - R01 CA1123790 | NIMH NIH HHS - R01 MH081098 |
Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.
Authors: Stone AL, Tai-Seale M, Stults CD, Luiz JM, Frankel RM
Source: Patient Educ Couns, 2012 Oct;89(1), p. 63-8.
EPub date: 2012 Jul 17.
PMID: 22809831
Related Citations
Grant Numbers:
| NIMH NIH HHS - R01MH081098 | NCI NIH HHS - R01CA1123790 | NIMH NIH HHS - R01 MH081098 |
MeSH Terms:
Factors associated with patient reports of positive physician relational communication.
Authors: Shay LA, Dumenci L, Siminoff LA, Flocke SA, Lafata JE
Source: Patient Educ Couns, 2012 Oct;89(1), p. 96-101.
EPub date: 2012 May 1.
PMID: 22554386
Related Citations
Grant Numbers:
| NCI NIH HHS - 1R01CA112379-01A1 |
MeSH Terms:
Prioritization of evidence-based preventive health services during periodic health examinations.
Authors: Shires DA, Stange KC, Divine G, Ratliff S, Vashi R, Tai-Seale M, Lafata JE
Source: Am J Prev Med, 2012 Feb;42(2), p. 164-73.
PMID: 22261213
Related Citations
Grant Numbers:
| NCI NIH HHS - R01 CA112379-01A1 | NCI NIH HHS - R01 CA112379-04S1 | NCI NIH HHS - 3R01CA112379-4S1 |
| NIMH NIH HHS - MH081098 |
MeSH Terms:
| Office Visits | Aged, 80 and over | Humans |
| Evidence-Based Practice | Preventive Health Services | Aged |
| Primary Health Care | Middle Aged | Physical Examination |
| Male | Female |
Patient-physician colorectal cancer screening discussions: delivery of the 5A's in practice.
Authors: Lafata JE, Cooper GS, Divine G, Flocke SA, Oja-Tebbe N, Stange KC, Wunderlich T
Source: Am J Prev Med, 2011 Nov;41(5), p. 480-6.
PMID: 22011418
Related Citations
Grant Numbers:
| NCI NIH HHS - R01 CA112379 |
MeSH Terms:
Patient-rated importance and receipt of information for colorectal cancer screening.
Authors: Flocke SA, Stange KC, Cooper GS, Wunderlich TL, Oja-Tebbe N, Divine G, Lafata JE
Source: Cancer Epidemiol Biomarkers Prev, 2011 Oct;20(10), p. 2168-73.
EPub date: 2011 Aug 3.
PMID: 21813727
Related Citations
Grant Numbers:
| NCI NIH HHS - R01 CA112379-01A1 | NCI NIH HHS - P30 CA43703 | NCI NIH HHS - R01 CA112379 |
MeSH Terms:
Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.
Authors: Wunderlich T, Cooper G, Divine G, Flocke S, Oja-Tebbe N, Stange K, Lafata JE
Source: Patient Educ Couns, 2010 Sep;80(3), p. 358-63.
EPub date: 2010 Jul 27.
PMID: 20667678
Related Citations
Grant Numbers:
| NCI NIH HHS - R01 CA112379-01A1 | NCI NIH HHS - R01CA1123790 |
MeSH Terms:
