Background: High quality clinical decision making is necessary to realize the full benefits of emerging cancer prevention and treatment strategies. Currently, patients and providers are often without the resources or skills to implement high quality decision making processes. Integrating expertise from the fields of cognitive psychology, medical economics, and health services research can improve cancer-related decision making research and practice. Career Goals: In this proposal, I seek to build a strong multidisciplinary research program at UNC in patient-oriented, cancer-related decision making that includes new research, mentorship of junior investigators, and creation of a UNC Center for Decision Making Research, with a goal of improving cancer care across the spectrum of prevention, treatment, and survivorship. These goals will be made possible during the K24 award through a reduction in other clinical and administrative responsibilities. New Research: I propose to devote 10% effort to new clinical research on the use of stated preference techniques to improve decision making in colorectal cancer screening. I will also develop additional expertise in the use of stated preference techniques for eliciting patient values through directed readings with health economists and a sabbatical to work with David Whynes, an expert in contingent valuation.


I will devote 40% effort to mentoring junior investigators at UNC, with a focus on junior faculty making the transition from mentored K awards to independent funding. I will continue to serve as faculty in the K30 and Cancer Control Fellowships and I will take on new trainees in the areas of cancer treatment and survivorship. My goal is to work intensively with 4-7 trainees at a time. Building Research Infrastructure: I will develop a UNC Center for Decision Making Research that will include an expanded decision support laboratory with increased space and personnel for formative and experimental research;a small grant program to provide my trainees with funding to perform pilot studies in cancer-related decision making;a speaker series for local and national inter-disciplinary collaboration and cross-fertilization on cancer decision making research;and expansion of our weekly working seminar for trainees and mentors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Scientist Award (K05)
Project #
Application #
Study Section
Subcommittee G - Education (NCI)
Program Officer
Perkins, Susan N
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Project End
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Budget End
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Fiscal Year
Total Cost
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University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
Zip Code
Dalton, Alexandra F; Golin, Carol E; Esserman, Denise et al. (2015) Relationship between Physicians' Uncertainty about Clinical Assessments and Patient-Centered Recommendations for Colorectal Cancer Screening in the Elderly. Med Decis Making 35:458-66
Reyna, Valerie F; Nelson, Wendy L; Han, Paul K et al. (2015) Decision making and cancer. Am Psychol 70:105-18
Jarmul, Jamie A; Pignone, Michael; Pletcher, Mark J (2015) Interpreting Hemoglobin A1C in Combination With Conventional Risk Factors for Prediction of Cardiovascular Risk. Circ Cardiovasc Qual Outcomes 8:501-7
Hutchins, Robert; Viera, Anthony J; Sheridan, Stacey L et al. (2015) Quantifying the utility of taking pills for cardiovascular prevention. Circ Cardiovasc Qual Outcomes 8:155-63
Cené, Crystal W; Haymore, Laura Beth; Lin, Feng-Chang et al. (2015) Family member accompaniment to routine medical visits is associated with better self-care in heart failure patients. Chronic Illn 11:21-32
Brenner, Alison; Howard, Kirsten; Lewis, Carmen et al. (2014) Comparing 3 values clarification methods for colorectal cancer screening decision-making: a randomized trial in the US and Australia. J Gen Intern Med 29:507-13
Wheeler, Stephanie B; Kuo, Tzy-Mey; Goyal, Ravi K et al. (2014) Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population. Health Place 29:114-23
Sheridan, Stacey L; Draeger, Lindy B; Pignone, Michael P et al. (2014) The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial. BMC Med Inform Decis Mak 14:14
Lewis, Carmen L; Esserman, Denise; DeLeon, Christopher et al. (2013) Physician decision making for colorectal cancer screening in the elderly. J Gen Intern Med 28:1202-7
Berg, Bjorn P; Murr, Michael; Chermak, David et al. (2013) Estimating the cost of no-shows and evaluating the effects of mitigation strategies. Med Decis Making 33:976-85

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