Here are some of the projects currently underway at the Health Decision Sciences Center and the Informed Medical Decisions Program:
PRomoting InforMEd Decisions about ColoRectal Cancer testing for older adults (PRIMED-CRC): Implementation Project
Years: 2024-2027
This dissemination & implementation project builds on the Promoting Informed Decisions about Colorectal Cancer Screening for Older Adults (PRIMED) Study which was a cluster randomized trial focused on decisions about continuing or stopping colorectal cancer (CRC) screening for adults aged 76-85. Based on the results and feedback from the PRIMED study and review of the literature, we identified two clear aims to advance the implementation of two interventions into routine care, (1) automating the reminder in the electronic health record (EHR) and streamlining the SDM training course, and (2) incorporating strategies (e.g. education, audit and feedback, and external facilitation) to promote use in a broader clinician population. Collaborating with 5 other sites, the objective of the D&I project project is to increase the frequency of discussions and improve the quality of conversations about colorectal cancer testing decisions with primary care clinicians and their older patients.
BREATHE STUDY: Boosting REsources And caregiver empowerment for Trach care at HomE
Years: 2023-2028
Collaborating with 5 other sites, the goals for this study are to reduce the burden on caregivers of children with tracheostomies, improve the safety and outcomes for children with tracheostomies who are living at home, and identify facilitators and barriers to implementation of the programs. This study will evaluate the effectiveness of two educational discharge programs to advance our understanding of how to support caregivers post-discharge.
Funding from the Patient-Centered Outcomes Research Institute (PCORI)
IMPACT SDM Study: IMproving treatment decisions for Patients with AortiC stenosis Through Shared Decision Making
Years: 2023-2028
Collaborating with 7 other sites, the goal for this study is to generate evidence of the effectiveness of a multi-faceted implementation strategy (a toolkit plus external facilitation) in promoting use of evidence-based SDM interventions (DAs and clinician training) to achieve SDM. This study will help the Heart Valve Teams ensure that patients are meaningfully involved in treatment decisions, well informed and receive treatments that reflect what matters most to them. The three aims of the study are: Aim 1: Determine effectiveness of the interventions (patient decision aid and clinician training) in achieving shared decision making, Aim 2: Determine the reach of the decision aids and adoption of training, and Aim 3: Explore potential mechanisms of effective implementation at the patient-, clinician- and clinic-level using mixed methods and identify barriers to sustained use.
Funding from the Patient-Centered Outcomes Research Institute (PCORI)
Development and implementation of electronic decision aids for genetic testing in inherited cancer syndromes
Years: 2020 – 2026
The major goals of this project are to develop two decision aids, evaluate whether they are as effective as a consult with a genetic counselor, and examine implementation of the tools into routine care across different healthcare settings.
Funding from the National Institutes of Health (NCI U01)
Enabling a Paradigm Shift: a Preference-tolerant RCT of Personalized vs. Annual Breast Cancer Screening
This is a large randomized trial comparing the effectiveness of annual mammography with personalized screening for breast cancer. The overall study is being run by Dr. Laura Esserman at University of California San Francisco, and Dr. Sepucha is co-leading the patient reported outcomes group to understand patients’ decision making about trial participation, adherence to screening recommendations, and the role of genetic testing on anxiety and regret among participants.
Funding from the Patient-Centered Outcomes Research Institute (PCORI)