Jon C. Tilburt, M.D.

The purpose of this study is to identify communication profiles of couples based on EMA and observational data. This aim will be addressed in two phases. In phase I, we will construct measures of empirically- and theoretically derived communication behaviors and patterns using our observational and EMA data. In Phase II, we will use these measures in latent profile analyses to identify distinct profiles of couples.

This one-month study is to gain input and recommendations from 20 Navajo women who are breast cancer survivors from Shiprock, NM and 20 Navajo women who are breast cancer survivors from Chinle, AZ. The women breast cancer survivors will identify one support person they’ve received while in treatment and follow-up services for 40 individuals who may live on or off Navajo Nation. The open-ended question is to figure out if all participants agree with a “ways of knowing” strategy to promote breast cancer screenings and self-check. The “ways of knowing” includes culturally based Navajo arts and crafts like storytelling, poem reading by Luci Tapahonso, basket making, etc., intertwined with breast cancer screenings. The results of the pilot study are to be included in a larger grant with the National Institutes of Health for a five-year intervention study.

In this research study, the investigators are working to help oncologists better serve patients by delivering more patient-centered, goal-concordant care that may improve health care delivery. - It is expected that about 30,000 patients and their oncologists will take part in this research study, 29,550 of these patients, the vast majority, will be included only for medical record review. At Mayo, 90 clinicians will participate along with 10,000 patients (9850 medical record review). Note that the minimum age of 65 pertains to the patient participants and not the clinicians. 

Communication is an important component of comprehensive cancer care impacting patient satisfaction, adherence, and quality of life. The wide array of issues addressed in cancer clinical interactions makes communicating about a broad range of topics (including quality of life, communication, symptom control, complementary/alternative therapies, costs, treatment burden, prognosis, anxiety, side-effects, sexual function, palliative care options, etc.) especially interesting and potentially challenging. Some of these topics may not be routinely addressed in the clinical interaction or may require consultative support from other members of the comprehensive cancer care team. One frequently overlooked critical element in research on communication between cancer clinicians, their patients, and their primary care clinicians is describing real-time consultations between patients and their clinicians. These interactions provide rich material for assessing key psycho-social dynamics and identifying issues that patients find important in their care. In order to devise systems of care that optimize the patient experience, it is critical that clinicians and researchers understand, appreciate, and systematically characterize the richness and complexity of the decision-making process in routine cancer consultations between cancer patients and their treating clinicians. This study seeks to assess the patient experience in cancer care by observing patients and their physicians in their clinical interactions and following them for several months to see how their care went. By describing in-depth the conversations and experiences of patients in these clinical interactions, this study will lay the foundation for practice-based interventions to optimize patients' interactions with their cancer care teams.

The purpose of this study is to interview patients and providers at Phoenix Indian Medical Center and Mayo Clinic Arizona to identify perceptions, experiences, and perceived factors influencing referrals and enrollment on clinical trials in the Department of Radiation Oncology at Mayo Clinic Arizona.

The overall goal of this line of research is to enhance the hospitality, cultural responsiveness, and efficiency with which a leading cancer center can collaborate with a neighboring treatment hub for an important, underserved population within that cancer center’s catchment area.

American Indian and Alaska Native people experience higher rates of cancer due to a variety of environmental, epigenetic, nutritional, and metabolic as well as socio-economic factors including limited access to and completion of state-of-the art therapies. AI/AN patients present with cancer at more advanced stages and have the worst 5 year cancer specific survival of all racial groups in the United States.1 Factors explaining this lower cancer survival remain elusive. Preliminary research has shown that Native Americans are at greater than 50% lower odds of receiving adjuvant therapy in primary cancers such as breast cancer and colon cancer.2[PSHM1] 

Despite all the pieces of a strong referral relationship with medical oncology and the significant opportunity offered by myriad trial protocols, there is a lack of consistent referral for second opinions and treatment for radiation therapy between Mayo Clinic and PIMC for patients, particularly those with breast and GI malignancies.