The Institute of Medicine recommends that providing """"""""access to high quality clinical trials"""""""" and """"""""policies to ensure full disclosure of information about appropriate treatment options"""""""" could improve clinical care. This revised application addresses these areas by investigating patient (PT) and physician (MD) communication behaviors and their relationship to treatment decisions, generally, and participating in a clinical trial, specifically. Previous work by the principal investigator has demonstrated that PT-MD communication is linked to patient decisions about treatment choices (i.e. whether to participate in a clinical trial) and that significant variability and problems exist in the ways physicians explain clinical trials and treatment options to patients and their families. The objective of this study is to demonstrate the role of PT-MD communication on treatment decision-making while considering predisposing factors of the patient (including sociodemographic variables, coping style, preference for information, perceived life expectancy), predisposing factors of the physician (sociodemographic and attitudinal), the features of the protocol and the impact of the presence of a key family member (usually a spouse) on the interaction. The central hypothesis is that the PT-MD interaction mediates the predisposing factors of the PT, MD and protocol and is therefore the important element in understanding and explaining cancer PT's decisions about treatment options. In addition, it is hypothesized that the presence and participation of a family member significantly increases the complexity of the interaction and needs to be systematically assessed to better understand how PTs make treatment decisions and how communication with MDs can be improved. The encounter in which a clinical trial is discussed is the observational unit. At Time 1, self-reported data on predisposing variables will be collected from 260 adult cancer patients (eligible for a Phase II or Phase III clinical trial and who have a key family member with them), and 50-68 MDs at two sites, the Moffit Cancer Center (Tampa) and the Cancer Center at the Albany Medical Center (Albany NY). At Time 2, the PT-MD interaction in (the presentation and discussion of the option to enroll in a clinical trial) will be videotaped. These data will be coded using the Moffit Accrual Analysis System (MAAS). Interactions between the family member and the MD also will be videotaped, coded and analyzed. At Time 3, an interview will be conducted with the patients to assess their decision, perceptions of factors leading to the decision, comfort level with the decision and the process, their sense of therapeutic alliance with the MD, and the role of the key family member in the decision-making process.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
1R01CA075003-01A3
Application #
6324031
Study Section
Special Emphasis Panel (ZRG1-RPHB-2 (01))
Program Officer
Kreps, Gary L
Project Start
2001-04-01
Project End
2004-03-31
Budget Start
2001-04-01
Budget End
2002-03-31
Support Year
1
Fiscal Year
2001
Total Cost
$501,288
Indirect Cost
Name
University of South Florida
Department
Public Health & Prev Medicine
Type
Organized Research Units
DUNS #
City
Tampa
State
FL
Country
United States
Zip Code
33612
Eggly, Susan; Barton, Ellen; Winckles, Andrew et al. (2015) A disparity of words: racial differences in oncologist-patient communication about clinical trials. Health Expect 18:1316-26
Barton, Ellen; Eggly, Susan; Winckles, Andrew et al. (2014) Strategies of persuasion in offers to participate in cancer clinical trials I: Topic placement and topic framing. Commun Med 11:1-14
Gleason, Marci E J; Harper, Felicity W K; Eggly, Susan et al. (2009) The influence of patient expectations regarding cure on treatment decisions. Patient Educ Couns 75:263-9
Eggly, Susan; Albrecht, Terrance L; Harper, Felicity W K et al. (2008) Oncologists'recommendations of clinical trial participation to patients. Patient Educ Couns 70:143-8
Eggly, Susan; Penner, Louis A; Greene, Meredith et al. (2006) Information seeking during ""bad news"" oncology interactions: Question asking by patients and their companions. Soc Sci Med 63:2974-85
Eggly, Susan; Penner, Louis; Albrecht, Terrance L et al. (2006) Discussing bad news in the outpatient oncology clinic: rethinking current communication guidelines. J Clin Oncol 24:716-9
Albrecht, Terrance L; Ruckdeschel, John C; Ray 3rd, Fountain L et al. (2005) A portable, unobtrusive device for videorecording clinical interactions. Behav Res Methods 37:165-9
Albrecht, Terrance L; Penner, Louis A; Ruckdeschel, John C (2003) Understanding patient decisions about clinical trials and the associated communication process: a preliminary report. J Cancer Educ 18:210-4