Decision Support Aids for Patient/Providers

Cathy MelvinMaria Fernandez

Jennifer Allen

Background

• Representation from 9 of 10 centers met 3 times

• Scope of current DAs research underway is broad, focuses on screening and treatment, a range of audiences, and several cancer types.

• Our review of published guidelines and recommendations on the use of DAs led us to a focus on two priority aims.

Aim 1: Close the knowledge gap about adoption and implementation of DAs in practice settings (measures, determinants, and outcomes)

Plan for Aim 1 We propose to

a) work with the Settings Work Group to develop and add questions about the use of decision support in clinic settings to the FQHC survey; and b) conduct qualitative inquiry in other practice settings in our network sites.

Aim 2: Design and test strategies for increasing adoption, implementation and evaluation of decision aids

Plan for Aim 2 We propose to develop a cross-center proposal (R01) for submission to the Dissemination and Implementation PAR in 2011 or 2012 to test strategies leading to implementation and evaluation of decision supports for prostate cancer screening and treatment in diverse practice settings.

Focus on Prostate Cancer

Questions of Particular Interest:

1) Interface between screening and treatment decision support2) Concordance – or lack of it – between provider

recommendation and patient preference3) Impact of availability and accessibility, particularly financial,

of screening and treatment options4) Design and test implementation processes to bundle “choice-

oriented” screening for a particular population group5) Variance in adoption and use across types of practices

Cross Center Project Criteria

1) Advances dissemination scienceDeveloping questions and measures focused on a variety of processes and outcomes related to adoption and implementation of decision supports

2) Is feasible with existing resourcesFirst phase is feasible with existing resources- we plan to seek funding for second phase.

3) Clearly identifies leadershipCathy Melvin (UNC), Maria Fernandez (UT), Jennifer Allen (Harvard)

Cross Center Project Criteria (continued)

4) Accounts for funder prioritiesAdvances the science of dissemination- how DAs can be more widely adopted and used in practice settings

5) Has impactInform field of measures to systematically and consistently assess issues affecting implementation of DAs in diverse practice settings, publication of findings, modification of DAs to address implementation issues, inform design of materials and implementation strategies for dissemination research.