National Cancer Institute
Behavioral Research - Cancer Control and Population Sciences

About Process of Care Research Branch (PCRB)

Mission: To support and encourage behavioral research on how individuals, teams, and health care organizations can act and interact more effectively to improve health through health care delivery.

Scientific Priorities: The Process of Care Research Branch (PCRB) focuses on behavioral issues in health care settings across the cancer continuum, from prevention and screening through diagnosis and treatment.

Specific research priorities are outlined according to Themes of Special Interest, however, PCRB encourages a broad array of studies and methodological approaches that increase understanding and promote behavioral interventions that affect health through health care delivery.

Supported research could include that which is focused upon:

  • Behaviors at one or more layers of the multilevel context that affects health through health care delivery (for example, addressing individual factors such as age, education, expectation, attitude, or health insurance)
  • Provider factors such as knowledge, attitude, teamwork, team structure
  • Organizational factors such as leadership support for the care team, type of electronic medical record, type of health care organization
  • Interactions between levels (for example, how people seeking care are treated by the health care team or how the health care team is affected by the health care organization)

A main point of scientific emphasis is patient-centered process and outcomes as ultimate measures of care.

Themes of Special Interest

Cancer Risk:

PCRB supports studies that address the role of risk in cancer control behaviors (diagnosis & treatment) including its influences upon and interaction with:

  • Delivery of personalized medicine
  • Risk assessment
  • Risk communication
  • Cultural interpretations of cancer and cancer control
  • Genetic and family history
  • Cancer screening behavior

Additional areas of research in the process of cancer care:

  • The relative importance of risk perception in people’s decision making compared to other factors such as affect, costs, or consequences
  • How risk is perceived and how that perception affects decisions of people seeking care or those providing it

Decision Making

As more patients become interested in shared healthcare decision making, additional research is needed to generate knowledge on how this process can be enhanced to improve health outcomes. PCRB is interested in understanding how the context of individual and provider discussions affect their decisions and how decisions are made in clinical care practice, with an emphasis on the primary care setting, but expanding into the diagnostic and treatment settings as appropriate to the scientific question. Some specific considerations include:

  • Health literacy
  • Attitudes towards informed decisions
  • Models of informed (shared) decision making
  • Patient-provider communication
  • Provider team effects
  • Mechanisms of behavior change
  • Individual characteristics (risk, age, ethnicity, education, income level etc.)
  • Contextual factors (time, setting, situation)

Contextual influences upon health and health behavior

PCRB is interested in studies that address contextual factors such as the provider team and health care organization that affect individual behavior and, therefore, health. This might include studies that examine and intervene at one or more levels of the multilevel context of care. It might also include observational studies or incorporate applications associated with system science.

Specific examples include:

  • Interventions to improve the follow-up of people with signs or symptoms of cancer including an abnormal screening test
  • Studies of interventions to improve the quality of care delivery as indicated by one or more of the following: safety, effectiveness, patient-centeredness, efficiency, timeliness and equality
  • Studies of methods to improve recruitment to clinical trials
  • Studies of the interactions between individuals (patients) and their health care providers, or individuals (patients and providers) and the health care system

Functional Statement

PCRB…

  1. Plans, develops, coordinates and maintains a comprehensive research program to explore how individuals, teams, and health care organizations can act and interact more effectively to improve health and health care delivery including programs in the following specific areas:
    1. The impact on the quality of health care delivery of the organizational, health care team, individual provider or patient factors
    2. Optimization of provider and team functioning within the health care environment
    3. Informed and/or shared decision making about screening and treatment recommendations, particularly when evidence is uncertain
    4. The role and relative importance of individual and contextual factors in decision making including consideration of age, ethnicity, organizational setting, and provider-patient interaction
    5. Understanding (of patient’s prioritization) of health care behaviors (screening, lifestyle, genetic testing, treatment choices) and preferences for participation in health care decisions
    6. Theory-based multilevel behavioral interventions in screening, diagnosis, and recruitment to clinical trials
    7. Interventions to increase the numbers of Americans from diverse socio-economic, cultural, racial and ethnic backgrounds who seek appropriate cancer screening and receive appropriate follow-up after screening
  2. Synthesizes and disseminates findings, recommendations and priorities to the general public, providers, and health care organizations
  3. Solicits feedback from and communicates regularly with the extramural community regarding scientific needs in the PCRB research areas
  4. Sponsors workshops, symposia and other means of disseminating research findings
  5. Participates in training programs
  6. Collaborates with other NCI Divisions, federal agencies, and private organizations to promote activities that share a common mission

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Last Updated: May 1, 2012
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