# Identifying Barriers to Patient-Centered Decision Making for Older Adults with Diverticulitis

> **NIH NIH R03** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $152,500

## Abstract

PROJECT SUMMARY/ABSTRACT
Diverticulitis affects hundreds of thousands of people over age 60 years in the United States and is the 4th most
common reason for emergency surgery in older adults. Due to the substantial consequences of diverticulitis,
patient-centered decision making is imperative for this vulnerable population. Existing frameworks for decision
making are inadequate for older adults facing surgery because they fail to incorporate the high-risk, irreversible
nature of surgical decisions and the unique considerations in older adults (for example, multiple comorbidity,
neurocognitive changes, and varying preferences regarding participation in decision making). The central
hypothesis of this proposal is that patient-centered decision making is not routinely achieved for older adults with
diverticulitis who are faced with a high-stakes decision about proceeding with surgery or observation. The
objective of this proposal is to guide the management of older adults facing high-risk surgery through the
identification of patient-centered decisions by accomplishing the following specific aims: 1) characterize the
decision making process for older adults with diverticulitis, including how patient/provider goals are incorporated
into treatment decisions, using a thorough and comprehensive evaluation of “real-time” evaluation of clinical
encounters followed by post-encounter interviews with patients and their providers and 2) identify barriers and
facilitators to patient-centered decision making using survey instruments informed by the findings of Aim 1 in a
large population of older adults with diverticulitis at multiple sites.
This is an innovative study that will address significant gaps in the literature regarding surgical decision making
for older adults with diverticulitis. This work represents a substantive departure from the existing literature, which
focuses on short term morbidity and mortality, by examining the complexity of surgical decision making between
older adults and their providers. The results will have a substantial impact because they can be used to 1) tailor
existing decision making frameworks for older adults making high-stakes surgical decisions and 2) define the
necessary components of a future decision support tool to support.
Dr. Cohan’s overall career goal is to become a leader at the intersection of colorectal surgery and aging-related
research that improves patient-centered surgical care for older adults. This project includes a comprehensive
professional development plan that incorporates mentorship and training to support this career goal. The
mentorship team is talented, diverse, and dedicated, spanning the disciplines of geriatrics, surgery, decision
science, and qualitative research. The proposed training in geriatric science and mixed-methods research will
allow Dr. Cohan to expand upon her prior clinical and research training. Together, the research and professional
development in this GEMSSTAR proposal will al...

## Key facts

- **NIH application ID:** 10028208
- **Project number:** 1R03AG067994-01
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Jessica N Cohan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $152,500
- **Award type:** 1
- **Project period:** 2020-09-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10028208

## Citation

> US National Institutes of Health, RePORTER application 10028208, Identifying Barriers to Patient-Centered Decision Making for Older Adults with Diverticulitis (1R03AG067994-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10028208. Licensed CC0.

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