Know Your Risk: Assessment at Screening for Breast Cancer - Pilot Study
Condition: Breast Neoplasms
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      The purpose of this pilot study is to evaluate a decision support website (RealRisks)
      designed to inform patients about breast cancer chemoprevention. It is coupled with a
      physician-centered (BNAV) decision support website as part of clinical workflow in the
      primary care setting. The investigator hypothesizes that improving accuracy of breast cancer
      risk perception and understanding of the risks/benefits of chemoprevention will enhance
      informed decision-making and uptake of breast cancer prevention strategies in the primary
      care setting.
    

Detailed description: 
      Breast cancer is the most common malignancy among women in the U.S. and the primary
      prevention of this disease is a major public health issue. The U.S. Preventive Services Task
      Force and other professional organizations recommend that clinicians discuss chemoprevention
      with high-risk women. Breast cancer chemoprevention with anti-estrogens, such as tamoxifen,
      raloxifene, exemestane, and anastrozole, is under-utilized, despite several randomized
      controlled trials demonstrating a 40-65% decrease in breast cancer incidence among high-risk
      women. Compounding this underutilization is the fact that a large proportion of women may be
      unaware of their high-risk status due to the investigators inability to adequately screen
      them in the primary care setting. Further research is needed to determine how knowledge about
      breast cancer, actual/perceived risk, and risks/benefits of chemoprevention are best
      communicated to women in order to promote breast cancer prevention strategies.

      This study assesses risk communication and shared decision-making in patient-clinician dyads
      by administering validated measures at baseline, after interacting with the tools prior to
      the clinic visit, and after the clinical visit (quantitative analysis); and by using
      observer-based methods of audio-tape recordings of their clinical encounters (qualitative
      analysis).

      The investigator hypothesizes that combining a patient-centered decision aid with a
      physician-centered decision support tool integrated into clinic workflow will improve
      accuracy of breast cancer risk perception, facilitate referrals for specialized risk
      counseling, and increase chemoprevention uptake.
    

Intervention name(s): RealRisks; BNAV
Intervention type(s): Other; Other
Intervention description(s): RealRisks is a web-based patient decision aid with modules that present information about risk assessment and chemoprevention.; Breast Cancer Risk Navigation (BNAV) tool is a web-based decision support tool with modules that present pertinent information for primary care providers regarding breast cancer risk assessment and preventative measures for their patients.
Other intervention name(s): RealRisks patient-centered decision aid (DA); Breast Cancer Risk Navigation (BNAV) tool; BNAV provider clinical decision support tool
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Breast Cancer Prevention; Risk Assessment; Chemoprevention; Decision Making