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Shared decision-making and colorectal cancer screening behaviors among older adults with low health literacy

Award Number: K23AG062795
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 01/15/2020
PERIOD OF PERFORMANCE END DATE: 12/31/2024

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Shared decision-making and colorectal cancer screening behaviors among older adults with low health literacy - Project Summary/Abstract The paradox of colorectal cancer (CRC) screening is that healthy older adults are often under-screened and those in poor health are over-screened. One study found that 51% of US adults >75 years with < 10 years of life expectancy were screened while 62% with >10 year LE were not. Guidelines recommend that adults >75 years make individualized decisions based on expectations of benefits, harms, values, and preferences. There is a gap in existing decision aids (DAs) designed for low health literate (LHL) adults >75 years to assist in making CRC screening decisions. This is concerning since risk factors (>75 years, low socioeconomic status, low educational levels, racial/ethnic minority status) for LHL are associated with low CRC knowledge of screening options, low self-efficacy, an apparent lack of desire to participate in SDM, and with less than optimal screening. The primary objective for this K23 application is to optimize CRC screening decisions and improve the quality of care among LHL adults 76-85 years with attention to differences by sex. The specific aims are to: 1. Identify the information needs and perceptions of LHL older adults about CRC screening; 2. Develop and modify short, paper-based pamphlet CRC DA for use with LHL older adults; and 3. Conduct a feasibility pilot randomized control trial of the CRC DA. Mixed qualitative (structured interviews, focus groups) and quantitative methods will be used to evaluate and test the “Making a decision about colon cancer screening” DA to create a simple, effective DA tool for use among cognitively intact older adults with LHL in four community based settings and three community health centers. The candidate's long-term goals are to become an independent health services researcher who develops health promotion interventions and improved decision support for underserved and underrepresented older adults with low health literacy. and secure independent research funding through NIH R01's and related awards such as “Increasing Uptake of Evidence-Based Screening in Diverse Adult Populations (PAR-18-932)” and “Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults; PA-17-109.” To the meet the research objective and career goal, the three training goals are to receive advanced training in:1. Developing skills in health literacy/health communication using mixed methodology; 2. Learning how to develop and evaluate decision support for LHL older adults; and 3. Designing and conducting randomized control trials. The research and career development will take place at Simmons University School of Social Work in collaboration with the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, where the candidate's primary mentor is located. The combination of resources at both institutions provide a very rich intellectual environment with relevant expertise to contribute substantially to the probability of success of the proposed study.


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 = $126,626 )
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	5	12/13/2023	NON-COMPETING CONTINUATION	$126,626
														Subtotal = $126,626

Issue Date FY: 2023 ( Subtotal = $126,780 )
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	000	4	2/8/2023	NON-COMPETING CONTINUATION	$126,780
														Subtotal = $126,780

Issue Date FY: 2022 ( Subtotal = $126,998 )
2022	2022	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	001	3	3/23/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$126,998
2022	2022	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Aging Research	003	3	5/16/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$65,498
2022	2021	SIMMONS UNIVERSITY	300 FENWAY	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	002	2	5/16/2022	NON-COMPETING CONTINUATION	-$65,498
2022	2021	SIMMONS UNIVERSITY	300 FENWAY	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	2	3/18/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $126,998

Issue Date FY: 2021 ( Subtotal = $126,484 )
2021	2021	SIMMONS UNIVERSITY	300 FENWAY	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	2	12/15/2020	NON-COMPETING CONTINUATION	$126,484
														Subtotal = $126,484

Issue Date FY: 2020 ( Subtotal = $127,018 )
2020	2020	SIMMONS UNIVERSITY	300 FENWAY	BOSTON	MA	02115	SUFFOLK	USA	Aging Research	000	1	1/10/2020	NEW	$127,018
														Subtotal = $127,018

Grand Total All Awards = $633,906

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Shared decision-making and colorectal cancer screening behaviors among older adults with low health literacy

Award Number: K23AG062795

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 01/15/2020

PERIOD OF PERFORMANCE END DATE: 12/31/2024

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