The National Palliative Care Research Center

Curing suffering through palliative care research.


James N. Dionne-Odom PhD, MSN, MA

Assistant Professor

University of Alabama at Birmingham

Grant Year
Grant Term
2 years
Grant Type
Pilot & Exploratory Project Support Grant

Project Description
An Optimization Trial to Prepare Advanced Cancer Family Caregivers for Decision Partnering using the Multiphase Optimization Strategy (MOST)

A priority focus in palliative care, oncology, and geriatrics is preparing the 2.8 million U.S. family caregivers of persons with cancer to effectively partner with patients in healthcare decision-making. Persons with cancer report involvement by relatives, friends, and partners in choices about treatments, surgery, care transitions, accessing palliative and hospice care, and many others. There is a critical need to train cancer caregivers to be supportive of patient decision-making; however, few palliative care interventions exist that enhance family decision partnering skills. Hence, we propose to optimize caregiver decision partnering training, based on content from our evidenced-based early palliative care model of early concurrent oncology palliative care, (ENABLE [Educate, Nurture, Advise, Before Life Ends]). Using the Multiphase Optimization Strategy (MOST) framework, the purpose of this study is to pilot, for the first time, an optimization trial approach to develop and refine strategies that specifically target the decision partnering skills of family caregivers of persons with advanced cancer. Using a 23 factorial design, 40 caregivers of persons with newly-diagnosed advanced cancer will be randomized to receive one or more nurse coach-delivered decision partnering training components: 1) psychoeducation on effective decision partnering principles (1 vs. 3 sessions); 2) communication training (yes vs. no); and 3) Ottawa Decision Guide training (yes vs. no). Specific aims: 1) determine the feasibility/acceptability of a factorial design to enroll 40 caregivers and 40 patients for 24 weeks to complete 1 or more components of ENABLE Caregiver decision partnering training; 2) explore the preliminary efficacy of individual intervention components and component combinations on patient and caregiver outcomes at 12 and 24 weeks after baseline, including a) patient-reported positive decision influence and b) patient and caregiver mood; and 3) examine mediators/moderators. Findings from this pilot will be used to acquire R01 funding to conduct a fully-powered MOST optimization trial.
J. Nicholas Dionne-Odom, PhD, APRN, ACHPN, FPCN is an Assistant Professor in the School of Nursing at the University of Alabama at Birmingham (UAB), Co-Director of Caregiver and Bereavement Support Services in the Center for Palliative and Supportive Care in the UAB Health System, and Associate Chair of the Palliative Care Research Cooperative Group Caregiver Core. He received his BSN from Florida State University, MA in Philosophy and Education from Teachers College, Columbia University, and MSN and PhD in Nursing from Boston College.. Dr. Dionne-Odom’s program of research focuses on developing and testing early palliative care coaching interventions to enhance support and skills of family caregivers of persons with advanced cancer and heart failure. He is also interested in decision psychology and decision support in the context of family caregiving/surrogate decision-making, lay navigation, telehealth coaching using behavioral activation techniques, minority and rural populations, implementation science, and optimization trials using the Multiphase Optimization Strategy (MOST).