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Using Patients' Stated Preferences to Inform and Support Proxy Decision-making during Palliative Treatment: Instrument Development and Evaluation

Award Number: F31CA254663
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

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Project Summary We will develop a discrete choice experiment (DCE) instrument to measure the trade-offs that advanced prostate cancer patients make when deciding among palliative anti-cancer treatment options. Only one out of three patients diagnosed with advanced prostate cancer is alive after five years. During disease progression, patient’s capacity for treatment decision making often wanes and decision partners undertake increased treatment decision making responsibility. This can result in elevated burden for decision partners, especially when there is uncertainty regarding the patients’ treatment preferences. Our proposed DCE will be designed to elicit patient treatment preferences to serve as a tangible guide to decision partners and the clinical team for future palliative anti-cancer treatment decision making. Importantly, the development process will focus on the inclusion of minority patients by oversampling African Americans and following models of decision making informed by research with African American participants. In Aim 1, Q methodology and qualitative interview techniques will be applied with patients and their decision partner to identify the important attributes of palliative anti-cancer treatment options and explore decision partners role in decision making. In Aim 2, a DCE instrument will be created and a subsequent sample of dyads (patient and decision partner) will be interviewed to engage patients and their decision partner in instrument development and initial piloting for validity and reliability. We will undertake a rigorous process to develop the DCE instrument following published best-practice guidelines. The output of this research project will include a DCE instrument to quantify patient’s palliative anti-cancer treatment preferences. This project will impact clinical practice by providing an objective measure of patients’ palliative anti-cancer treatment preferences to decision partners and the clinical team that can help guide treatment decisions. Future research will investigate the potential role of DCEs in decision support. This award will support the research, training, and professional development necessary for the Applicant to transition into a career advancing decision support research to mitigate health disparities and reduce negative outcomes for patients and their decision partners, including stress, anxiety, guilt, and depression. Upon completion of this Fellowship, the Applicant will have a solid foundation for future research to investigate decision support, beginning with a career development award to test the developed DCE instrument in larger samples to derive generalizable results. This application is aligned with the National Cancer Institute Scientific Priority Area of preventing, understanding, and mitigating cancer health disparities due to our unique focus on inclusive sampling. The Applicant is well supported to accomplish this goal with a Sponsor and Cosponsor who have a long history of working together productively in the area of cancer health disparities, and collaborators with expertise in the scientific areas relevant to the proposed research.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Cancer Research Manpower	000	2	8/30/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $44,208 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Cancer Research Manpower	000	2	8/1/2023	SUPPLEMENT FOR EXPANSION	$44,208
														Subtotal = $44,208

Issue Date FY: 2022 ( Subtotal = $39,964 )
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Cancer Research Manpower	000	2	7/19/2022	NON-COMPETING CONTINUATION	$39,964
														Subtotal = $39,964

Issue Date FY: 2021 ( Subtotal = $46,036 )
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Cancer Research Manpower	000	1	4/30/2021	NEW	$46,036
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Cancer Research Manpower	001	1	4/30/2021	NEW	$0
														Subtotal = $46,036

Grand Total All Awards = $130,208

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Using Patients' Stated Preferences to Inform and Support Proxy Decision-making during Palliative Treatment: Instrument Development and Evaluation

Award Number: F31CA254663

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

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