NCT03282097

Brief Summary

The Decisions about Cancer screening in Alzheimer's Disease (DECAD) study tests if an evidence-based decision aid for dementia caregivers can support decision-making about mammography and improve the quality of medical decision-making about breast cancer screening. This large randomized controlled trial will recruit up to 450 dyads (900 individual participants) of older women with dementia and a family caregiver, for a goal of 426 dyad baselines (852 individual participants).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
442

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Dec 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

5 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 11, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

September 13, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

December 1, 2017

Completed
5.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 6, 2023

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

June 7, 2024

Completed
24 days until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2024

Completed
Last Updated

August 11, 2025

Status Verified

August 1, 2025

Enrollment Period

5.3 years

First QC Date

September 11, 2017

Results QC Date

April 8, 2024

Last Update Submit

August 5, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Decisional Conflict Scale

    The Decisional Conflict Scale (DCS) includes 16-items on a 1-5 Likert scale. Questions are regarding a medical decision that participants have made or that they are about to make; it measures uncertainty around a decision, whether one feels informed, clear about their personal values, and supported in their decision-making It is a validated and widely accepted measure of decision quality that has been used in previous studies of decision aids intended for AD caregivers. Scores can range from 0-100, with lower scores indicating less conflict. This survey is completed during the baseline and Post-Index PCP visit.

    Change in DCS score from Baseline to post-PCP Index Visit. Post-PCP Index visit routinely occurs 0-5 days after the patient's index visit with their PCP.

Secondary Outcomes (5)

  • Change in Decision-making Self-efficacy Scale Score

    Change in Decision Self-Efficacy score from Baseline to post-PCP Index Visit. Post-PCP Index visit routinely occurs 0-5 days after the patient's index visit with their PCP.

  • Caregiver Role in Decision Making

    The above values represent the number of caregivers that completed the assessment at post-PCP Index Visit. Post-PCP Index visit routinely occurs 0-5 days after the patient's index visit with their PCP.

  • Receipt of Mammogram Screening

    15 month post intervention

  • Change in Caregiver Knowledge About Mammograms in Older Women With ADRD

    Change in Caregiver knowledge from Baseline to post-PCP Index Visit. Post-PCP Index visit routinely occurs 0-5 days after the patient's index visit with their PCP.

  • Caregiver Intention for the Patient to Receive Mammogram Screening in the Future

    Post-PCP Index visit routinely occurs 0-5 days after the patient's index visit with their PCP.

Study Arms (2)

Mammogram decision aid

EXPERIMENTAL

Family caregivers and patients with dementia will be mailed the DECAD decision aid about mammography and breast cancer screening before the patients next PCP visit to test if the aid improves decision making about breast cancer screening in older women with dementia.

Behavioral: DECAD decision aid

Home safety guide

ACTIVE COMPARATOR

Family caregivers and patients with dementia will be mailed a home safety guide, which is a two-page paper pamphlet developed by the American Geriatrics Society Foundation for Health in Aging. It provides tips about important actions older adults can take to prevent falls, poisoning, and bathroom hazards and protection against abuse, fire and other related hazards. We selected the home safety guide to account for the attention given to the intervention group but not to provide information that would bias the control group about mammography.

Other: Home safety guide

Interventions

A mammography decision aid directed toward family caregivers of older women with Alzheimer's disease and other dementias to assist with decisions about breast cancer screening.

Mammogram decision aid

The home safety guide to provide tips about important actions older adults can take to prevent falls, poisoning, and bathroom hazards and protection against abuse, fire and other related hazards.

Also known as: control group
Home safety guide

Eligibility Criteria

Age75 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • Female and 75 years or older
  • At least one mammogram in the past five years
  • Primary care visit scheduled in the next 12 months
  • Diagnosis of Alzheimer's disease or related dementia as determined by ICD-10 code
  • Ability to provide informed consent or assent
  • Ability to communicate in English

You may not qualify if:

  • Permanent resident of a nursing facility
  • Had a mammogram in the past 6 months
  • Primary care visit scheduled is the first visit with the PCP
  • Made a decision to stop getting mammograms
  • History of Atypical Ductal Hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, or non-invasive breast cancer
  • Has mild cognitive impairment, serious mental illness such as bipolar or schizophrenia as determined by ICD-10 code
  • years or older
  • Primary family caregiver of the patient\*
  • Must have a telephone
  • Ability to provide informed consent
  • Ability to communicate in English
  • Caregiver is a non-family member who is not a legal Healthcare Power of Attorney
  • Less than a 7th grade education\*\*
  • Made a decision that the patient will stop getting mammograms
  • Has a diagnosis of AD or has a serious mental illness such as bipolar or schizophrenia as determined by ICD-10 code

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (5)

Parkview Health

Fort Wayne, Indiana, 46805, United States

Location

Alzheimer's Association

Indianapolis, Indiana, 46220, United States

Location

Eskenazi Health

Indianapolis, Indiana, 46220, United States

Location

IU Health

Indianapolis, Indiana, 46220, United States

Location

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

Related Publications (1)

  • Fowler NR, Schonberg MA, Sachs GA, Schwartz PH, Gao S, Lane KA, Inger L, Torke AM. Supporting breast cancer screening decisions for caregivers of older women with dementia: study protocol for a randomized controlled trial. Trials. 2018 Dec 12;19(1):678. doi: 10.1186/s13063-018-3039-z.

MeSH Terms

Conditions

Breast NeoplasmsAlzheimer Disease

Interventions

Control Groups

Condition Hierarchy (Ancestors)

Neoplasms by SiteNeoplasmsBreast DiseasesSkin DiseasesSkin and Connective Tissue DiseasesDementiaBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesTauopathiesNeurodegenerative DiseasesNeurocognitive DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Epidemiologic Research DesignEpidemiologic MethodsInvestigative TechniquesResearch DesignMethods

Results Point of Contact

Title
Nicole R. Fowler, PhD, MHSA; Associate Professor of Medicine
Organization
Indiana University School of Medicine; Indiana University Center for Aging Research; Regenstrief Institute, Inc.

Study Officials

  • Nicole Fowler, PhD

    Indiana University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor of Medicine

Study Record Dates

First Submitted

September 11, 2017

First Posted

September 13, 2017

Study Start

December 1, 2017

Primary Completion

April 6, 2023

Study Completion

July 1, 2024

Last Updated

August 11, 2025

Results First Posted

June 7, 2024

Record last verified: 2025-08

Data Sharing

IPD Sharing
Will not share

Locations