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Congratulations to Drs. Jennifer Elston Lafata and Angela Smith for receiving two separate awards aimed at improving the delivery, quality, and equity of care for patients facing cancer screening and treatment.

For both projects Dr. Elston Lafata serves as the principal investigator and Dr. Smith will act as a clinician co-investigator focusing on prostate cancer patients for each respective area. Research will be carried out with the support of the UNC Lineberger Comprehensive Cancer Center, one of the leading cancer centers in the nation and the only public comprehensive cancer center in the state of North Carolina. Both Drs. Elston Lafata and Smith are members of the UNC LCCC and work on multidisciplinary teams within the center.

Development of a Shared Decision Making Support (SDM-S) Measure for Use with Team-based Care

The Agency for Healthcare Research and Quality (AHRQ) grant will support the work to develop a shared decision-making subscale. This new subscale is different from existing measures of shared decision making in that it considers the decision-making support patients receive from each of the different care team members across four decision-making phases: choice awareness, consideration of alternatives/preferences, choice-making, and choice implementation.

It is important to be able to measure and understand decision-making quality within and across these decision-making phases as health care providers and others explore new and innovative ways to implement shared decision making in their practice.

Identifying Opportunities to Pursue Equity When Implementing Virtual Visits in Oncology Care

Genentech’s grant will further support the study of the implementation successes, challenges, and opportunities afforded by virtual visits as brought on by the rapid scaling during the COVID-19 pandemic. Of specific interest is how these pertain to achieving equity in care access and reducing racial disparities in outcomes.

The study seeks to address two overarching practice-relevant, research questions: 1) how are oncology care organizations considering equity as they design new virtual visit programs, and 2) how virtual visits may hinder or enhance care access and affect outcomes among Black adults diagnosed with cancer?

For this project the investigators will be partnering with the Henry Ford Health System, a non-profit health care organization based in Metro Detroit.


“Dr. Elston Lafata is an international leader of innovative quality improvement initiatives, and I am thrilled to join her research team to tackle these two timely and relevant areas within cancer care: achieving equity when implementing virtual visits and defining shared decision-making throughout a patient’s cancer journey.”

Angela Smith, MD, MS
Vice Chair of Academic Affairs
Director of Urologic Oncology
Associate Professor of Urology


About Dr. Elston Lafata

Dr. Jennifer Elston Lafata is a Professor of Pharmaceutical Outcomes and Policy at the University of North Carolina Eshelman School of Pharmacy.

In addition to her faculty roles, she currently serves as an Associate Director in the UNC Institute for Healthcare Quality Improvement, and co-lead of the UNC Cancer Care Quality Initiative. In these roles she works closely with members of UNC Health Care to coach and support quality improvement initiatives and the development of infrastructure for an Oncology Care Population Management System.

Dr. Lafata’s research seeks to improve cancer and diabetes care quality via improved decision making and patient-provider communication. She has extensive experience conducting practice-integrated research and working with delivery organizations to develop, implement and evaluate interventions designed to improve cancer and other care delivery. Her research has been supported by NIH, AHRQ, PCORI, RWJ and industry.

About Dr. Angela Smith

Dr. Angela Smith is the Director of Urologic Oncology at the UNC Lineberger Comprehensive Cancer Center and primarily treats GU malignancies, including bladder, prostate, and kidney cancer.

Dr. Smith has a background in health services research and biostatistics and has an interest in patient-centered outcomes research, risk stratification, and quality of care for invasive bladder cancer.

Dr. Smith is the co-PI for a PCORI large pragmatic trial in BCG refractory bladder cancer, PI for a PCORI Engagement Award with the Bladder Cancer Advocacy Network to engage patients in the research process, and has been funded by an AHRQ K08 grant that integrates patient-reported outcomes into post-cystectomy care through mobile health technology.

Dr. Smith has also served on the PCORI Advisory Panel for the Assessment of Prevention, Diagnosis, and Treatment Options, representing clinicians. Dr. Smith also serves as the Assistant Secretary of the American Urological Association and has recently served on the AUA Quality Improvement and Patient Safety Committee, Scientific Advisory Board for the Bladder Cancer Advocacy Network, Journal of Urology Editorial Board, and is the current chair of the Urology Care Foundation Bladder Health Committee.