Keene

Researchers are conducting a three-arm randomized pilot trial to improve mammography decision-making for women aged 39 to 49 in rural primary care settings. The study aims to test the feasibility of a decision aid called MyMammogram, with or without additional provider communication, to help patients and primary care providers engage more effectively in breast cancer screening decisions. The trial focuses on recruitment, retention, adherence, and acceptability of the interventions among patients and providers. Participants will be assigned to one of three groups usual care, using the MyMammogram decision aid before their appointment, or using MyMammogram plus having their provider receive a summary of their breast cancer risk and screening preferences before the visit. The trial will enroll 30 participants in two phases, allowing the research team to refine protocols and address barriers to participation. The intervention is delivered online, and providers receive summarized patient information in one group. During the study, participants will complete surveys before the intervention, after using the decision aid, and following their primary care visit. Researchers will collect mammography screening data from medical records and gather feedback from patients and clinicians about the interventions acceptability and trial experience. The main outcome measured is how acceptable the intervention is to participants, evaluated within one day of completion. Feasibility measures such as recruitment and retention will also be assessed over several weeks, with the total study completion expected in September 2026.

Researchers are evaluating a structured clinical visit agenda-setting intervention called Chronic Kidney Disease CKD Topics in people with advanced CKD stages 4-5, many living in rural areas. This open pilot aims to practice the use of the intervention and surveys before a larger pilot stepped wedge clinical trial. The study focuses on testing procedures for identifying eligible participants, administering the intervention, and conducting surveys. Participants will receive the CKD Topics intervention, which includes eight structured discussion topic areas allowing patients to prioritize topics and take notes before, during, and after clinical visits. The intervention is delivered as a quality improvement tool during outpatient visits, including both in-person and telehealth formats. This pilot study has only one intervention arm and will inform procedural changes for a future larger trial. Throughout the study, participants will be screened for eligibility and then engage with the CKD Topics intervention during their clinical visits. Researchers will collect information on the feasibility of intervention receipt and the administration of outcome and other questionnaires. The study will monitor the intervention delivery and participant responses to determine if the procedures work effectively. The total study duration is from May 2026 to September 2026.