A number of CPDE projects focus on evaluation and research in clinical settings on initiatives testing new interventions, creating decision support tools, and using patient and provider feedback to improve healthcare delivery.
Health and healthcare-delivery projects include:
MaPGAS (Decision-making in Metoidioplasty and Phalloplasty Gender Affirming Surgery)
CPDE has partnered with urology surgeon Dr. Rachel Moses and colleagues at DHMC and the University of Utah to explore the decision-making factors of those considering transmasculine genital reconstruction surgery (TMGRS) to inform the development of a surgical decision aid. CPDE is conducting semi-structured interviews with a mix of individuals pre- and post-GRS and providers from the two sites to identify the information needs and supports of those considering TMGRS. Participants also complete a number of standardized measures to assess quality of life, physical health, gender congruence, mental well-being, and decisional conflict. Data will be combined with results of a systematic literature review and Delphi study with a team of transgender medical experts to create a prototype TMGRS decision aid which includes surgical options, outcome probabilities and risks. (Funder: National Institutes of Health)
New Hampshire Colorectal Cancer Screening Program
The goal of NHCRCSP is to increase high quality colorectal cancer screening rates at partnering primary care clinics and health centers in New Hampshire. NHCRCSP staff members work with partner sites to implement and strengthen strategies that have been shown to improve quality and completions of colorectal cancer screenings. CPDE collaborates with the NHCRCSP team to design a readiness assessment tool of partner clinics and perform program evaluation including annual assessment of partners’ progress, facilitators to implementing interventions, and challenges and barriers with implementation. (Funder: Centers for Disease Control and Prevention)
COOP Study (Colonoscopy vs Stool Testing in Older Adults with Colon Polyps)
CPDE is working with Dr. Audrey Calderwood and her team on a PCORI grant, the Colonoscopy vs Stool Testing in Older Adults with Colon Polyps (COOP) Study, which compares fecal immunochemical testing (FIT) to colonoscopy for surveillance in older adults with a history of colon polyps. Our team has supported this project through the development and validation of a patient-reported outcome measure (PROM) to assess secondary outcomes. (Funder: Patient-Centered Outcomes Research Institute (PCORI))
RELIEF Study (Reduced-dose onabotulinumtoxinA for urgency incontinence among older women)
CPDE is working with Dr. Anne Cooper and Dr. Elizabeth Ann Gormley at Dartmouth Health to conduct a mixed methods analysis as part of a larger randomized controlled clinical trial (RCT) across six health systems in the US. The multi-site RCT is assessing the effectiveness of a lower dose versus the standard dose of Botox for the treatment of urinary incontinence for women age 70 and older. The study design includes a qualitative study where in-depth interviews are conducted with a subset of RCT participants at two points in time (before treatment and/or 3 months after treatment) about their experience seeking treatment, treatment decision making, barriers and facilitators to care, and the impact of urinary incontinence on quality of life. CPDE is conducting the mixed methods analysis combining data from the qualitative arm of the study with the quantitative results from the RCT to bring a depth of understanding of participant experiences and context to the results. (Funder: Patient-Centered Outcomes Research Institute (PCORI))