The FYI on MRI: A Multilevel Decision Support Intervention for Screening Breast MRI

MRI 仅供参考：用于筛查乳腺 MRI 的多级决策支持干预措施

• 批准号: 10591106
• 负责人: Claire C Conley
• 金额: $ 19.43万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-05 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10591106
• 关键词: Address; Age; American Cancer Society; American College of Radiology; Awareness; Behavioral; Biopsy; Black race; Breast; Breast Cancer Detection; Breast Cancer Risk Assessment Tool; Breast Cancer Risk Factor; Breast Magnetic Resonance Imaging; Cancer Burden; Cancer Etiology; Capital; Caring; Cessation of life; Clinic; Clinical; Communities; Community Clinical Oncology Program; Complement; Comprehensive Cancer Center; Conflict (Psychology); Data; Decision Aid; Decision Making; Development; Diagnosis; Disparity; District of Columbia; Early identification; Effectiveness of Interventions; Environment; Epidemiologist; Future; Goals; Guidelines; High Risk Woman; Individual; International; Intervention; Interview; K-Series Research Career Programs; Knowledge; Latina; Magnetic Resonance Imaging; Mammographic screening; Mammography; Medical; Mentors; Mentorship; Modality; National Breast and Cervical Cancer Early Detection Program; National Comprehensive Cancer Network; National Institute on Minority Health and Health Disparities; Not Hispanic or Latino; Nurse Practitioners; Oncologist; Participant; Patient Preferences; Patient-Centered Care; Patients; Persons; Population; Population Heterogeneity; Positioning Attribute; Protocols documentation; Race; Randomized; Recommendation; Research; Research Support; Risk; Risk Assessment; Scientist; Screening for cancer; Site; System; Testing; Training; Training Programs; Translating; United States Preventative Services Task Force; Woman; Work; black women; cancer diagnosis; cancer risk; career; community engaged research; community setting; cost; cultural values; effectiveness testing; experience; high risk; intervention effect; lifetime risk; malignant breast neoplasm; patient level intervention; patient navigation; patient navigator; post intervention; preference; prevent; primary outcome; programs; randomized trial; risk prediction model; satisfaction; screening; screening guidelines; secondary outcome; skills; treatment as usual

PROJECT SUMMARY The proposed K08 career development award will provide Dr. Conley with the training and mentorship necessary to become an independent clinical scientist focused on leveraging multilevel approaches to support informed decision making about risk-based cancer screening in diverse populations. She has identified decision-making about screening breast MRI among high-risk Black and Latina women as a critical issue to address in order to achieve this goal. This proposal describes a 5-year comprehensive program of training and mentored research for an academic career at the intersection of medical decision making and risk-based cancer screening. This K08 will provide key training in community engaged research, medical decision making, multilevel interventions, and cancer risk prediction models. The intensive research experience provided by the K08 aims will provide the opportunity to implement and practice the skills gained through the training goals. The primary objective of the proposed research is to develop and test a multilevel intervention to support informed decision making about screening breast MRI among high-risk Black and Latina women. Women at high risk for breast cancer (i.e., ≥20% lifetime risk) can decide to supplement mammography screening with MRI or continue with mammography alone. Some women will benefit from screening with breast MRI, though some will experience harms due to the higher rate of biopsies, false-positive results, and higher costs. Thus, informed decision making about screening breast MRI is critical for high-risk women. An informed decision is defined as a decision that is made with sufficient knowledge, and is in line with the person’s preferences. To make informed decisions about screening breast MRI, high-risk women must: (1) be identified as high risk; (2) be made aware that breast MRI is an option; (3) understand MRI’s benefits and drawbacks; and (4) make a decision aligned with their preferences. However, lack of awareness and access may prevent high-risk Black and Latina women from making an informed decision about breast MRI. The study’s specific aims are: (1) develop and deliver a universal breast cancer risk assess- ment protocol in a community setting; (2) develop a culturally-relevant decision aid with input from diverse stake- holders; and (3) assess the effect of the multilevel decision support intervention (i.e., risk assessment + decision aid) on informed decisions about breast MRI. Dr. Conley’s mentorship team – including world-renowned behav- ioral scientists, clinical trialists, breast oncologists, epidemiologists, and biostatisticians – will provide guidance to support her research aims and complement her didactic training. These factors, in addition to the supportive research environment at Georgetown Lombardi Comprehensive Cancer Center, will enable her to achieve the proposed project aims. The proposed study will provide pilot data for a future R01 application to test the effec- tiveness of this intervention in the NCI Community Oncology Research Program. Dr. Conley will also possess the skills and experience to leverage multilevel approaches to support informed decision-making about risk- based cancer screening in diverse populations. This will result in sustained and impactful scientific contributions.

项目概要 拟议的 K08 职业发展奖将为康利博士提供必要的培训和指导 成为一名独立的临床科学家，专注于利用多层次的方法来支持知情的 关于不同人群基于风险的癌症筛查的决策她已经确定了决策。 关于对高风险黑人和拉丁裔女性进行乳房 MRI 筛查作为一个需要解决的关键问题，以便 该提案描述了一个为期 5 年的综合培训和指导研究计划。 从事医疗决策和基于风险的癌症筛查交叉领域的学术职业。 K08 将提供社区参与研究、医疗决策、多层次干预、 K08 目标提供的深入研究经验将提供 有机会实施和练习通过培训目标获得的技能。 拟议的研究是开发和测试多层次干预措施，以支持明智的决策 对乳腺癌高危女性（即≥20%）进行乳房 MRI 筛查。 终生风险）可以决定用 MRI 补充乳房 X 光检查筛查或继续单独进行乳房 X 光检查。 一些女性会从乳房 MRI 筛查中受益，但也有一些女性会因较高的检查而受到伤害。 活检率、假阳性结果和更高的成本因此，有关乳房筛查的明智决策。 MRI 对于高危女性至关重要。明智的决定是指在充分考虑的情况下做出的决定。 知识，并符合个人的喜好，以做出有关乳房筛查的明智决定。 MRI，高风险女性必须：(1) 被确定为高风险；(2) 意识到乳房 MRI 是一种选择；(3) MRI 的优点和缺点；以及 (4) 做出符合他们偏好的决定。 缺乏意识和机会可能会阻止高风险黑人和拉丁裔妇女做出明智的决定 关于乳腺 MRI，该研究的具体目标是：(1) 制定并提供通用乳腺癌风险评估。 (2) 根据不同利益相关者的意见制定与文化相关的决策辅助工具 （3）评估多层次决策支持干预的效果（即风险评估+决策支持） 援助）关于康利博士的指导团队的明智决策 - 包括世界知名的行为 - 口腔科学家、临床试验人员、乳腺肿瘤学家、流行病学家和生物统计学家——将提供指导 除了支持性之外，还支持她的研究目标并补充她的教学培训。 乔治城隆巴迪综合癌症中心的研究环境将使她能够实现 拟议的项目目标。拟议的研究将为未来的 R01 应用提供试点数据，以测试其效果。 Conley 博士也将拥有 NCI 社区肿瘤​​学研究计划中这一干预措施的积极性。 利用多层次方法支持有关风险的明智决策的技能和经验 基于不同人群的癌症筛查，这将带来持续且有影响力的科学贡献。