# Informed/Shared Decision Making for Prostate Cancer Screening Among Members of the World Trade Center Health Program

> **NIH ALLCDC U01** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $499,929

## Abstract

Abstract
The World Trade Center (WTC) attacks caused unprecedented occupational and environmental exposures for
hundreds of thousands of individuals. There have been myriad health effects from these exposures, including
cancer, respiratory, gastrointestinal, and mental health consequences. The proposed study is based on the
scientific premise, that cancer rates are elevated among those exposed to the WTC attacks, as documented
by recent findings; however, prostate cancer (PCa) screening, which is elevated in WTC exposed individuals,
is not offered through the WTC Health Program (WTCHP). The proposed research provides an opportunity to
evaluate an informed/shared PCa screening decision approach for members of the WTCHP. Through three
specific aims, we plan to Aim 1: adapt a stepped decision making approach for PCa screening among WTCHP
members and train physicians in shared decision making; Aim 2: implement a stepped decision making
approach within the Queens WTCHP and identify the proportion of WTCHP who agree to be screened, the
psychosocial and demographic factors affecting participants screening decision, and the psychosocial and
clinical outcomes of accepting/rejecting PCa screening; and Aim 3: record the cost of implementing PCa
screening among members of the WTCHP. We hypothesize that psychiatric morbidity is associated with lower
screening utilization, and that screening is associated in the short-term with elevated distress, which will
dissipate over time.
This study is highly relevant, since PCa is the second most common cancer in the WTCHP, and many of the
participants have co-morbidities that can influence their clinical decision making. The use of a informed/shared
decision making approach is recommended for PCa screening, and could be applied to screening tests offered
within the WTCHP. The investigators are uniquely suited to do this work, with prior expertise in WTC health
effects and monitoring and in decision support for PCa. The project is innovative, in that no other WTCHP is
using a stepped informed/shared decision approach in clinical care. Cost assessment for future implementation
efforts is also innovative. The project is significant, as results have the potential to improve care for the
thousands of WTCHP members. This project is also responsive to the participant’s needs, since the request for
PCa screening is frequent in the WTCHP. Overall, the proposed project is innovative and significant as it
addresses unmet cancer control needs among a highly at-risk population and addresses potential adverse
psychosocial consequences of screening efforts.

## Key facts

- **NIH application ID:** 9940896
- **Project number:** 5U01OH011690-04
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Michael A Diefenbach
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2020
- **Award amount:** $499,929
- **Award type:** 5
- **Project period:** 2018-07-01 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9940896

## Citation

> US National Institutes of Health, RePORTER application 9940896, Informed/Shared Decision Making for Prostate Cancer Screening Among Members of the World Trade Center Health Program (5U01OH011690-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9940896. Licensed CC0.

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