Grant Number:	1R01CA112379-01A1 Interpret this number
Primary Investigator:	Elston Lafata, Jennifer
Organization:	Henry Ford Health System
Project Title:	Physician Recommendation and Colorectal Cancer Screening
Fiscal Year:	2006

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.




"Mm-hm," "Uh-uh": are non-lexical conversational sounds deal breakers for the ambient clinical documentation technology?
Authors: Tran B.D. , Latif K. , Reynolds T.L. , Park J. , Elston Lafata J. , Tai-Seale M. , Zheng K. .
Source: Journal Of The American Medical Informatics Association : Jamia, 2023-03-16 00:00:00.0; 30(4), p. 703-711.
PMID: 36688526
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Automated rating of patient and physician emotion in primary care visits.
Authors: Park J. , Jindal A. , Kuo P. , Tanana M. , Lafata J.E. , Tai-Seale M. , Atkins D.C. , Imel Z.E. , Smyth P. .
Source: Patient Education And Counseling, 2021 08; 104(8), p. 2098-2105.
EPub date: 2021-01-07 00:00:00.0.
PMID: 33468364
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Lower Adherence: A Description of Colorectal Cancer Screening Barrier Talk.
Authors: Johnson Shen M. , Elston Lafata J. , D'Agostino T.A. , Bylund C.L. .
Source: Journal Of Health Communication, 2020; 25(1), p. 43-53.
EPub date: 2019-12-04 00:00:00.0.
PMID: 31795843
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Periodic health examinations and missed opportunities among patients likely needing mental health care.
Authors: Tai-Seale M. , Hatfield L.A. , Wilson C.J. , Stults C.D. , McGuire T.G. , Diamond L.C. , Frankel R.M. , MacLean L. , Stone A. , Elston Lafata J. .
Source: The American Journal Of Managed Care, 2016-10-01 00:00:00.0; 22(10), p. e350-e357.
EPub date: 2016-10-01 00:00:00.0.
PMID: 28557520
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Assessment of the Efficiency of Tobacco Cessation Counseling in Primary Care.
Authors: El-Shahawy O. , Shires D.A. , Elston Lafata J. .
Source: Evaluation & The Health Professions, 2016 09; 39(3), p. 326-35.
EPub date: 2015-08-18 00:00:00.0.
PMID: 26290271
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Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.
Authors: Lafata J.E. , Shay L.A. , Brown R. , Street R.L. .
Source: Health Services Research, 2016 Apr; 51(2), p. 728-45.
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Physician use of persuasion and colorectal cancer screening.
Authors: Lafata J.E. , Wunderlich T. , Flocke S.A. , Oja-Tebbe N. , Dyer K.E. , Siminoff L.A. .
Source: Translational Behavioral Medicine, 2015 Mar; 5(1), p. 87-93.
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Managed care patients' preferences, physician recommendations, and colon cancer screening.
Authors: Hawley S. , Lillie S. , Cooper G. , Elston Lafata J. .
Source: The American Journal Of Managed Care, 2014 Jul; 20(7), p. 555-61.
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Sexual health discussions with older adult patients during periodic health exams.
Authors: Ports K.A. , Barnack-Tavlaris J.L. , Syme M.L. , Perera R.A. , Lafata J.E. .
Source: The Journal Of Sexual Medicine, 2014 Apr; 11(4), p. 901-8.
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Patient-physician colorectal cancer screening discussion content and patients' use of colorectal cancer screening.
Authors: Lafata J.E. , Cooper G. , Divine G. , Oja-Tebbe N. , Flocke S.A. .
Source: Patient Education And Counseling, 2014 Jan; 94(1), p. 76-82.
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Patients with mental health needs are engaged in asking questions, but physicians' responses vary.
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Source: Health Affairs (project Hope), 2013 Feb; 32(2), p. 259-67.
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Factors associated with patient reports of positive physician relational communication.
Authors: Shay L.A. , Dumenci L. , Siminoff L.A. , Flocke S.A. , Lafata J.E. .
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Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.
Authors: Stone A.L. , Tai-Seale M. , Stults C.D. , Luiz J.M. , Frankel R.M. .
Source: Patient Education And Counseling, 2012 Oct; 89(1), p. 63-8.
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Prioritization of evidence-based preventive health services during periodic health examinations.
Authors: Shires D.A. , Stange K.C. , Divine G. , Ratliff S. , Vashi R. , Tai-Seale M. , Lafata J.E. .
Source: American Journal Of Preventive Medicine, 2012 Feb; 42(2), p. 164-73.
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Patient-physician colorectal cancer screening discussions: delivery of the 5A's in practice.
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Source: American Journal Of Preventive Medicine, 2011 Nov; 41(5), p. 480-6.
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Patient-rated importance and receipt of information for colorectal cancer screening.
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Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2011 Oct; 20(10), p. 2168-73.
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Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.
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Source: Patient Education And Counseling, 2010 Sep; 80(3), p. 358-63.
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Patient-physician colorectal cancer screening discussions and screening use.
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Source: American Journal Of Preventive Medicine, 2006 Sep; 31(3), p. 202-9.
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Authors: Foo P.K. , Frankel R.M. , McGuire T.G. , Zaslavsky A.M. , Lafata J.E. , Tai-Seale M. .
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