# Messaging Strategies to Reduce Breast Cancer Over-Screening in Older Women

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $329,747

## Abstract

PROJECT SUMMARY
This administrative supplement aims to reduce unnecessary or inappropriate care in older adults with
Alzheimer’s disease and related dementias (AD/ADRD), using breast cancer over-screening as a case study.
Mammography screening may decrease breast cancer mortality and morbidity, but the potential benefits are
often delayed for many years while significant harms can occur in the short term. The harms of routine
screening outweigh the benefits among older women with limited life expectancies, but many of these women,
including those with AD/ADRD, continue to be screened.
 The parent project (R01AG066741) is studying the novel use of messaging interventions to reduce
over-screening in the general population but does not focus on older women with AD/ADRD. Breast cancer
screening decisions in AD/ADRD patients may differ in process (e.g., caregiver involvement), decisional
factors, and communication. We propose in this supplement to examine whether the messaging strategies
developed in the parent grant will be acceptable and effective for older women with AD/ADRD and their
caregivers. The supplement also builds upon the parent project to examine AD/ADRD patients and caregivers’
decision-making about stopping breast cancer screening, which can serve as a case study to provide key
insights on the de-implementation of other unnecessary or inappropriate preventive care where short-term
harms outweigh delayed benefits.
 We propose to examine the perspectives of older women with AD/ADRD and their caregivers, including
how they make breast cancer screening decisions and consider de-implementation, and feedback on the
messaging strategies for reducing breast cancer over-screening from the parent project. We will conduct
qualitative interviews of 15-20 older women with AD/ADRD and 15-20 caregivers (Aim 1) and quantitative
survey of 400 caregivers for older women with AD/ADRD recruited from a nationally representative online
panel (Aim 2). Lastly, we will leverage stakeholder engagement that is already planned in the parent project for
devising messaging strategies. We propose to add stakeholders relevant to AD/ADRD patients and to expand
discussion to de-implementation of breast cancer over-screening in patients with AD/ADRD.
 The proposed supplement will 1) enhance the parent project by ensuring that the developed messaging
strategies are applicable to older women with AD/ADRD, and 2) provide key preliminary data on other
intervention approaches for de-implementing breast cancer over-screening and other unnecessary or
inappropriate care in older adults with AD/ADRD.

## Key facts

- **NIH application ID:** 10937283
- **Project number:** 3R01AG066741-04S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Nancy Schoenborn
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $329,747
- **Award type:** 3
- **Project period:** 2021-04-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10937283

## Citation

> US National Institutes of Health, RePORTER application 10937283, Messaging Strategies to Reduce Breast Cancer Over-Screening in Older Women (3R01AG066741-04S1). Retrieved via AI Analytics 2026-06-15 from https://api.ai-analytics.org/grant/nih/10937283. Licensed CC0.

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