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Grant Details

Grant Number: 5R01CA098966-10 Interpret this number
Primary Investigator: Kahana, Eva
Organization: Case Western Reserve University
Project Title: Health Care Partners in Cancer Prevention and Care Among Aged - Competing Renewal
Fiscal Year: 2015


Abstract

DESCRIPTION (provided by applicant): We plan to implement a novel, community based educational program to inform and motivate underserved older adults to forge partnerships with their doctors, targeting cancer prevention as a shared goal. Using a randomized controlled trial (RCT), we will evaluate the efficacy of our social learning theory based intervention that promotes patient participation in order to enhance patient centered medical care. This study builds on findings of our ongoing study of Health Care Partnerships in Cancer Prevention and Care. Specifically we propose a multi-modal health communication training program for older adults. This educational intervention ("Speak Up" program), aims to improve patient initiative, competence, and confidence in communication with physicians. Based on foundations of social learning theory the intervention is expected to result in increased discussion between older adults and their primary care physicians about cancer prevention and screening. Participants in the intervention are also expected to receive more age and risk specific preventive advice from their doctors and report greater satisfaction with their health care. Participants in the "Speak Up" facilitated discussion groups (N=480) will be compared to participants in "Connect" attention control groups (N=480). The latter program addresses important goals of enhancing civic and social engagement. The intervention program will be conducted in small groups and offer user-friendly experiential learning including information, discussion, and role play in order to help older persons develop better communication skills. The study will be conducted among randomly selected community dwelling elders who had participated in our prior research, and among community based older adults who attend Senior Center nutrition programs, sponsored by Area Agencies on Aging (AAA). Based on comparing pre-intervention assessments with 2 week, 6 month, and 12 month telephone follow-up evaluations, we will determine both the short term and long term impact of the intervention. We will consider participants' personal characteristics and their physicians' background and supportiveness as they may influence uptake of the intervention. We designed the study based on intervention research (CONSORT) guidelines for conducting RCTs, and will carefully evaluate treatment fidelity. In addition to patient reported outcomes, we will also consider objective indices based on Medicare claims data and AAA data on program utilization. We will use multilevel models with fixed and random effects in our quantitative data analyses. Using a mixed methods design, we will also include a qualitative study component based on in-depth interviews with 60 participants selected based on high versus low program benefits. Our study is closely aligned with the mission of the National Cancer Institute to improve cancer control and to reduce health disparities in cancer prevention and care. We plan an active dissemination effort to insure that this portable and cost effective intervention may be widely adopted by community organizations such as Area Agencies on Aging that serve diverse older adults.



Publications

Elderly Cancer Survivors Reflect on Coping Strategies During the Cancer Journey.
Authors: Kahana E. , Kahana B. , Langendoerfer K.B. , Kahana B. , Smith-Tran A. .
Source: Journal of gerontology & geriatric research, 2016 Oct; 5(5), .
EPub date: 2016-08-19.
PMID: 29057171
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Patient Planning and Initiative Enhances Physician Recommendations for Cancer Screening and Prevention.
Authors: Kahana E. , Lee J.E. , Kahana B. , Langendoerfer K.B. , Marshall G.L. .
Source: Journal of family medicine & community health, 2015; 2(9), .
EPub date: 2015-12-19.
PMID: 29376127
Related Citations

Changes over time in the utilization of disease-related Internet information in newly diagnosed breast cancer patients 2007 to 2013.
Authors: Kowalski C. , Kahana E. , Kuhr K. , Ansmann L. , Pfaff H. .
Source: Journal of medical Internet research, 2014-08-26; 16(8), p. e195.
EPub date: 2014-08-26.
PMID: 25158744
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Baby boomers' expectations of health and medicine.
Authors: Kahana E. , Kahana B. .
Source: The virtual mentor : VM, 2014-05-01; 16(5), p. 380-4.
EPub date: 2014-05-01.
PMID: 24847709
Related Citations

Proactive approaches to successful aging: one clear path through the forest.
Authors: Kahana E. , Kahana B. , Lee J.E. .
Source: Gerontology, 2014; 60(5), p. 466-74.
EPub date: 2014-06-11.
PMID: 24924437
Related Citations

Altruism, helping, and volunteering: pathways to well-being in late life.
Authors: Kahana E. , Bhatta T. , Lovegreen L.D. , Kahana B. , Midlarsky E. .
Source: Journal of aging and health, 2013 Feb; 25(1), p. 159-87.
PMID: 23324536
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The impact of transportation support on driving cessation among community-dwelling older adults.
Authors: Choi M. , Adams K.B. , Kahana E. .
Source: The journals of gerontology. Series B, Psychological sciences and social sciences, 2012 May; 67(3), p. 392-400.
EPub date: 2012-03-27.
PMID: 22454388
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Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life.
Authors: Kahana E. , Kelley-Moore J. , Kahana B. .
Source: Aging & mental health, 2012; 16(4), p. 438-51.
EPub date: 2012-02-02.
PMID: 22299813
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Determinants of altered life perspectives among older-adult long-term cancer survivors.
Authors: Kahana B. , Kahana E. , Deimling G. , Sterns S. , VanGunten M. .
Source: Cancer nursing, 2011 May-Jun; 34(3), p. 209-18.
PMID: 21522060
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Toward advocacy in cancer care for older adults: survivors have cautious personal actions but bold advice for others.
Authors: Kahana E. , Kahana B. , Kelley-Moore J. , Adams S.A. , Hammel R. , Kulle D. , Brown J.A. , King C. .
Source: Journal of the American Geriatrics Society, 2009 Nov; 57 Suppl 2, p. S269-71.
PMID: 20122027
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Joint modeling of longitudinal changes in depressive symptoms and mortality in a sample of community-dwelling elderly people.
Authors: Zhang J.P. , Kahana B. , Kahana E. , Hu B. , Pozuelo L. .
Source: Psychosomatic medicine, 2009 Sep; 71(7), p. 704-14.
EPub date: 2009-07-10.
PMID: 19592521
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Marshalling Social Support: A "Care-Getting" Model for Persons Living with Cancer.
Authors: Kahana E. , Kahana B. , Wykle M. , Kulle D. .
Source: Journal of family social work, 2009-04-01; 12(2), p. 168-193.
PMID: 20107524
Related Citations

When do older adults become "disabled"? Social and health antecedents of perceived disability in a panel study of the oldest old.
Authors: Kelley-Moore J.A. , Schumacher J.G. , Kahana E. , Kahana B. .
Source: Journal of health and social behavior, 2006 Jun; 47(2), p. 126-41.
PMID: 16821507
Related Citations

Motivational Antecedents of Preventive Proactivity in Late Life: Linking Future Orientation and Exercise.
Authors: Kahana E. , Kahana B. , Zhang J. .
Source: Motivation and emotion, 2005 Dec; 29(4), p. 438-459.
PMID: 18080009
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Gerontology at Case Western Reserve University: A History of Pioneering Scholarship.
Authors: Settersten R.A. , Kahana E. .
Source: Contemporary gerontology, 2005; 11(4), p. 149-153.
PMID: 18080010
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