# Testing the efficacy of a decision aid and planning tool for family building after cancer

> **NIH NIH R37** · STANFORD UNIVERSITY · 2024 · $555,692

## Abstract

Project Summary/Abstract
Up to 93% of young adult female (YA-F) cancer survivors report fertility distress; 30-46% meet criteria for
moderate-severe fertility-related trauma. Gonadotoxic cancer treatments can cause infertility, early
menopause, or problems getting pregnant and carrying a pregnancy to term. Family building after cancer often
requires in vitro fertilization, surrogacy, or adoption, which have medical/physical, psychosocial, financial, legal,
and logistical barriers. Prior work shows that YA-Fs are unprepared for the challenges of family building after
cancer, have unrealistic expectations (such as overestimating the likelihood of success), and risk missing their
narrowed reproductive window and experiencing greater difficulty, distress, and higher costs than expected.
The long-term goal of the proposed research is to improve oncofertility care in post-treatment survivorship. We
propose to test the efficacy of the Roadmap to Parenthood software, an interactive web-based decision aid
and planning tool for family building after cancer for YA-F survivors (18-45 years old; assigned female at birth)
and explore its implementation potential. First, we will conduct a rigorous 12-month randomized controlled trial
(Aim 1). YA-F cancer survivors (N=256) will be randomized into the (a) Roadmap intervention condition or (b)
time and attention control condition that includes a web-based young adult cancer survivorship informational
booklet. Surveys will be administered at baseline (pre-intervention) and 1-, 6-, and 12-month follow up
timepoints. We hypothesize the intervention group compared to the control group will report lower decisional
conflict about family building (primary outcome), more planning behaviors aligned with family-building goals
(e.g., fertility testing, financial planning), and improved quality of life (secondary outcomes). Then, we will test
mediators and moderators of intervention efficacy (Aim 2). We hypothesize age, partnership status, fertility
preservation history, and engagement with the decision aid will moderate the relationship between the
intervention and decisional conflict, and increased levels of knowledge and self-efficacy and improved
communication with providers will mediate the intervention effect on decisional conflict. Finally, we will evaluate
future implementation potential of the Roadmap tool in clinical settings (Aim 3). Guided by the Capability-
Opportunity-Motivation Behavior (COM-B) implementation model, we will conduct qualitative interviews with
providers representing four specialties (N=32; 8 from each) to understand barriers and facilitators to the
implementation of the Roadmap tool across clinics. Providers working in diverse settings in oncology, primary
care, gynecology, and reproductive medicine, all of whom address reproductive health clinically, will be
included. Themes related to barriers/facilitators within the categories of ‘capability’ (e.g., skills, knowledge),
‘opportunity’ (e.g., re...

## Key facts

- **NIH application ID:** 10927303
- **Project number:** 5R37CA282148-02
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Lidia Schapira
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $555,692
- **Award type:** 5
- **Project period:** 2023-09-08 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10927303

## Citation

> US National Institutes of Health, RePORTER application 10927303, Testing the efficacy of a decision aid and planning tool for family building after cancer (5R37CA282148-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10927303. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*