The National Palliative Care Research Center

Curing suffering through palliative care research.


Jennifer Snaman MD

Assistant Professor

Dana-Farber Cancer Institute

Grant Year
Grant Term
2 years
Grant Type
Kornfeld Scholars Program

Project Description
MyPref: A Communication and Decision-Making Tool for Adolescent and Young Adult Patients with Advanced Cancer

Background: Adolescent and young adults (AYAs) with cancer often receive high intensity care and experience significant symptoms at the end of life (EOL). Additionally, AYAs experience inferior survival and worse quality of life outcomes compared to younger children or older adults. Given therapeutic innovations, AYAs, their parents or trusted persons (PTPs), and providers, face progressively more treatment options, each with unique risk/benefit profiles, requiring trading one desirable outcome for another. AYAs often face multiple treatment-related decisions and yet they are not consistently included in conversations around preferences for care. The multiple, complex medical decisions require novel tools to amplify the AYAs’ role in decision-making and augment communication. We have developed MyPref, a communication and decision-making intervention to quantify AYA preferences and train AYAs, their PTPs and oncologist to have preference-based discussions about for future cancer treatment with the goal of improving care in this vulnerable AYA population. Hypothesis: We hypothesize that use of the MyPref and associated training curriculum will augment communication and improve shared medical decision-making between AYAs with advanced cancer, their PTPs, and providers. Design: Single-arm, mixed-methodology study in 40 AYAs with advanced cancer,40 PTPs, and 15 oncologists to further develop and test the MyPref intervention (MyPref survey with preference summary and communication and training curriculum) with post-survey assessment of utility of MyPref in augmenting decision-making and communication, and pilot testing of outcomes of decisional conflict and regret in patients (N=10) that experience further disease progression. Relevance: AYAs with advanced cancer are at risk for high intensity care and poor quality of life at end of life, which may not align with their preferences. Completion of this study and the proposed career development plan are the first steps in development of my NCI K08 application to support a comparative trial of MyPref in AYA patients with advanced cancer.

Jennifer Snaman, MD, MS is an Assistant Professor in the Department of Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute in Boston, MA. She received her MD from Eastern Virginia Medical School and her MS in Population Biology from Emory University. Following her Pediatric Residency at the Boston Combined Residency Program, she completed a combined training fellowship in Pediatric Hematology-Oncology and Hospice and Palliative Medicine at St. Jude Children’s Research Hospital in Memphis, TN in 2016. She returned to Boston in August 2017 as pediatric oncologist and palliative care clinician and researcher. Her research interests include decision-making and communication needs in adolescent and young adult (AYA) patients with advanced cancer with an aim to improve goal-concordant care in this population.

Email: Jennifer_Snaman@DFCI.HARVARD.EDU