Carmen Lewis MD MPH is a candidate for the Cancer Prevention, Control and Population Sciences Career Development Award (K07). Her long-term career goal is to establish an independent research program to advance evidence based patient-centered care for adults in late life. Achieving the proposed career development objectives will ensure that the candidate has the skills necessary to be a successful independent researcher. The career development plan includes coursework to expand the candidate's research skills, tutorials to obtain content expertise in areas relevant to cancer screening in older adults, long-term research planning and mentored research. The rationale for the proposed research is that age appropriate colon cancer screening in adults age 75 and over is achieved with accurate physician estimates of patient longevity and patient centered decision making.
Three aims are proposed.
Specific Aim 1 is to understand primary care physicians' attitudes and decision making processes for colon cancer screening in older adults. It will be achieved with qualitative methods, specifically physician focus groups.
For Specific Aim 2, a national survey of practicing physicians will be performed to determine physicians' abilities to make age appropriate screening recommendations in regards to three key elements: knowledge about the life expectancy needed to benefit from screening, uncertainty in estimating the benefit of screening from health states, and promotion of patient centered decision making. These results will inform Specific Aim 3, to develop and test the feasibility of a physician prompt combined with a decision support tool to promote age appropriate screening. The results from this study will be used to develop a multi-site randomized control trial of this intervention to determine its effect on colon cancer screening rates in healthy adults age 75 and over and the frequency of patient centered decision making. With this award Dr Lewis will be prepared to make significant contributions to cancer prevention and control in the aging U.S. population. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA104128-03
Application #
7276066
Study Section
Subcommittee G - Education (NCI)
Program Officer
Silkensen, Shannon M
Project Start
2005-09-15
Project End
2010-08-31
Budget Start
2007-09-01
Budget End
2008-08-31
Support Year
3
Fiscal Year
2007
Total Cost
$136,343
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Lewis, Carmen L; Dalton, Alexandra F; Drake, Lauren et al. (2016) Developing and Evaluating a Clinic-Based Decision Aid Delivery System. MDM Policy Pract 1:2381468316656850
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
Watson, Lea C; Esserman, Denise A; Ivey, Jena L et al. (2014) Enhancing Quality in Psychiatry with Psychiatrists (EQUIPP)--results from a pilot study. Am J Geriatr Psychiatry 22:884-8
Hansen, Richard A; Esserman, Denise A; Roth, Mary T et al. (2013) Performance of Medometer visual tool for measuring medication adherence and comparison with other measures. J Am Pharm Assoc (2003) 53:198-205
Pignone, Michael P; Brenner, Alison T; Hawley, Sarah et al. (2012) Conjoint analysis versus rating and ranking for values elicitation and clarification in colorectal cancer screening. J Gen Intern Med 27:45-50
Lewis, Carmen L; Brenner, Alison Tytell; Griffith, Jennifer M et al. (2012) Two controlled trials to determine the effectiveness of a mailed intervention to increase colon cancer screening. N C Med J 73:93-8
Miller, Kylee M; Brenner, Alison; Griffith, Jennifer M et al. (2012) Promoting decision aid use in primary care using a staff member for delivery. Patient Educ Couns 86:189-94
Cox, Christopher E; Lewis, Carmen L; Hanson, Laura C et al. (2012) Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Crit Care Med 40:2327-34
Pignone, Michael; Winquist, Andrea; Schild, Laura A et al. (2011) Effectiveness of a patient and practice-level colorectal cancer screening intervention in health plan members: the CHOICE trial. Cancer 117:3352-62
Arroyave, Ana Maria; Penaranda, Eribeth K; Lewis, Carmen L (2011) Organizational change: a way to increase colon, breast and cervical cancer screening in primary care practices. J Community Health 36:281-8

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