SDM POSSIBLE: A Cluster RCT of a Breast Cancer Treatment Decision Aid for Women 70+ With Low-Risk Stage I Breast Cancers
Investigators aim to conduct a type 1 hybrid effectiveness-implementation surgeon-level cluster randomized clinical trial (RCT) of a multi-level intervention, a shared decision making training for surgeons plus patient decision aid vs. usual care (UC), at 7 large health systems across the U.S. to learn the intervention's effectiveness. Decision aids will be mailed and sent via patient portal and/or via email (when portal/email addresses are available) to patients before their first surgical encounter. The central hypothesis is that the novel intervention will be a key resource to support shared decision making leading to higher quality treatment decisions and as result improved care and outcomes.
• Non-resident surgeon \>18 years old
• Cares for women \>/= 70 years at one of the recruitment practices.
• Ability and willingness to provide verbal consent
• Biological female
• aged 70 or older
• first primary invasive breast cancer
• clinically \</=2 cm
• clinically lymph node negative
• estrogen receptor positive (ER+) -HER2-
• scheduled with a participating surgeon for an initial encounter. Females with ER+ breast cancer will be included regardless of their progesterone receptor (PR) status since treatment decisions are similar for ER+/PR+ and ER+/PR- women.
• Biological female
• aged 70 or older
• a first primary invasive breast cancer
• clinically \</=2 cm
• clinically lymph node negative
• estrogen receptor positive(ER+) -HER2-
• saw a participating surgeon for an initial encounter in the year before the surgeon completed the baseline questionnaire.
• Biological female
• aged 70 or older
• first primary invasive breast cancer
• clinically \</=2 cm
• clinically lymph node negative
• estrogen receptor positive (ER+) -HER2-
• scheduled with a participating surgeon for an initial encounter. If a patient completes the baseline questionnaire and then is found to have different tumor characteristics (e.g., found to be lymph node positive during surgery), investigators plan to retain the patient in the study and ask them to complete the second survey.
• primary family, friend, or non-paid caregiver (herein referred to as caregiver) of a patient unable or unwilling to complete study questionnaires due to cognitive decline. The primary family, friend, or non-paid caregiver will be identified by the patient, self-identified, or documented as the decision maker in the medical record.
• Age \>18
• English or Spanish speaking
• Ability and willingness to provide verbal consent
• Administrator, social worker, physician assistant, navigator, nurse or other allied health professional in breast surgery
• Ability and willingness to provide verbal consent