PRIMARY OBJECTIVES:~Stage 1: To evaluate patient-participants' decisional conflict about precision oncology.~Stage 2: To develop a Decision Support Intervention (DSI) to improve decision-making about precision oncology~SECONDARY OBJECTIVES:~Stage 1:~To evaluate patient-participants' precision oncology knowledge~To evaluate patient-participants' perceived shared decision-making effort~To evaluate the degree of decision support provided by provider-participants' during an appointment with the patient-participant.~To evaluate patient-participants' and caregiver-participants' decisional needs, potential solutions, and potential disparities about precision oncology~To evaluate patient-participants' decisional needs and to identify potential disparities about precision oncology from the perspective of the provider-participant.~To evaluate how many patient-participants receive precision oncology intervention or testing after having an appointment and discussion with a provider-participant~Stage 2:~1. To describe the multi-stakeholder development process of the DSI~Military Veterans with an upcoming hematology/oncology visit in which germline testing, somatic testing, or targeted therapy will be discussed. Decision-making for precision oncology will be characterized and their decisional needs assessed. Patients, caregivers, and physicians will participate in both Stage 1 and Stage 2, occurring in parallel. The investigators and stakeholders will then design and evaluate a DSI based on the results and feedback received in both stages.
This project proposes to understand and improve Veterans' decision-making in precision oncology (germline testing, somatic tumor testing, and targeted therapy) for advanced prostate cancer. As precision oncology expands, a comprehensive strategy to support patient informed decision- making (IDM) has not been developed.