Low-dose computed tomography (LDCT) lung cancer screening has become the standard of care for high-risk groups in the US, and the case for implementation of stratified screening is building in the UK. Despite a 20% reduction in lung cancer mortality (Aberle et al, 2011), LDCT screening is not without harms, and in accordance with healthcare policy in Wales (Bradley et al, 2014; Atherton et al, 2016) patients need to be educated about the potential benefits, harms and limitations of screening so that they make a decision that is right for them. Lung cancer disproportionately affects individuals from disadvantaged communities in Wales, and if LDCT screening is to be introduced, we need to understand how we can best support disadvantaged populations to become involved in shared decision making regarding their lung screening decision in a way that avoids widening socioeconomic inequalities in lung cancer outcomes.
The aim of the proposed PhD is to understand how we can best support shared decision making regarding low-dose computed tomography in high-risk disadvantaged populations in Wales, with a view to developing a patient decision support intervention.
Specific objectives are:
1) Undertake a literature search to scope existing decision support interventions for LDCT lung cancer screening and to identify evidence of pros and cons of LDCT screening 2) Identify decision-making needs and involvement preferences regarding LDCT lung cancer screening in disadvantaged populations to inform the optimal type and timing of decision support, using novel participatory qualitative methodologies 3) Examine primary care and community healthcare professionals’ knowledge of and attitudes towards patient involvement in LDCT screening decisions using quantitative and qualitative methodologies 4) Co-develop pilot-intervention content and delivery plans using community engagement and co-production approaches 5) Evaluate intervention acceptability and feasibility in a small-scale pilot study
Given that the case for stratified screening is building in Wales and across the UK, this provides an ideal opportunity to start planning for implementation across Wales and to truly co-produce an intervention with patients and providers so that we minimise social inequality. By working in close partnership with the key stakeholders, the evidence from these PhD studies will be used to model a shared decision making LDCT screening pathway in Wales, inform the specification for a further feasibility and pilot trial, and generate new knowledge regarding methods of engaging disadvantaged groups in shared decision making.
The studentship is generously funded by the School of Medicine Full UK/EU tuition fees Doctoral stipend matching UK Research Council National Minimum Additional funding is available over the course of the programme and will cover costs such as research consumables and training. Applicants should possess a minimum of an upper second class Honours degree, master's degree, or equivalent in a relevant subject. Applicants whose first language is not English are normally expected to meet the minimum University requirements (e.g. 6.5 IELTS)
In order to be considered you must submit a formal application via Cardiff University’s online application service. (To access the system click 'Apply Online' at the bottom of this advert) There is a box at the top right of the page labelled ‘Apply’, please ensure you select the correct ‘Qualification’ (Doctor of Philosophy), the correct ‘Mode of Study’ (Full Time) and the correct ‘Start Date’ (October 2019). This will take you to the application portal. Candidates are only permitted to submit one application but may select a maximum of three projects, ranked in order of preference in the ‘Research Proposal’ section of the application. In order to be considered candidates must submit the following information:
• Supporting statement • CV • Qualification certificates • References x 2 • Proof of English language (if applicable)