# Patient Risk Perception and Decision-Making about Adherence to Repeat Cancer Scr

> **NIH VA I01** · EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL · 2024 · —

## Abstract

Background: VA seeks to promote patient-centered care in which Veterans' personal values and goals drive
health care plans. Involving patients in their care can produce better health outcomes. We currently have little
understanding of how Veterans make decisions about returning for repeat screening, including how results of
prior screening tests affect their risk perceptions, and how other sources of information influence adherence
decisions. The Knowledge-Empowerment-Values and Health Belief models have been applied to decisions
about screening uptake. This study will extend that model to account for repeat screening decisions.
Significance: Patients' decisions to engage in routine screening and return for repeat screening are at the
core of the success or failure of VA initiatives to improve screening. Using breast cancer screening (BCS) and
lung cancer screening (LCS) as cases, this work will generate greater understanding of how perceptions of risk
change throughout the screening process. We will develop patient-driven materials for information that can
given to patients prior to screening, as well as included in the reporting of screening results, that can inform
communication between providers and patients decision-making that is Veteran-centered. These findings will
also be able to be extended beyond lung and breast cancer screening to other cancer screening programs.
Innovation and Impact: This study is unique in that we will be using multiple programs of cancer screening
as cases to understand repeat screening decision-making. Lung cancer and breast cancer screening are
cases with important similarities and differences that offer opportunities to more fully examine the many factors
that Veterans consider when deciding to return, or not, for repeat screening. In doing so, we will develop a
broader understanding of how Veterans engage with the screening process and how perceptions of risk
change throughout this process. This may also inform the implementation of shared decision-making and
patient-centered care in screening programs for other conditions that involve repeated routine screenings.
Specific Aims: Aim 1-Characterize elements that influence patients' decisions about repeat cancer screening.
 Aim 1a – Ascertain how veterans who are undergoing lung and breast cancer screening interpret the
results of screening exams, revise their perceptions of risk, and make decisions about repeat LCS and BCS.
 Aim 1b – Identify factors that influence how Veterans make decisions about repeat cancer screening.
The focus will be on determining the variety of sources of information Veterans have utilized as they refine their
perceptions of risk and vulnerability, and an evaluation of the styles and formats they feel would be useful.
Aim 2 – Contrast the perceptions of risk and the screening experiences of Veterans undergoing lung and
breast cancer screening to specify a model of decision-making in repeat cancer screening.
Aim 3 – Develop patient-driv...

## Key facts

- **NIH application ID:** 10739721
- **Project number:** 5I01HX003242-03
- **Recipient organization:** EDITH NOURSE  ROGERS MEMORIAL VETERANS HOSPITAL
- **Principal Investigator:** Christopher Gillespie
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2021-10-01 → 2026-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10739721

## Citation

> US National Institutes of Health, RePORTER application 10739721, Patient Risk Perception and Decision-Making about Adherence to Repeat Cancer Scr (5I01HX003242-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10739721. Licensed CC0.

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