# Developing decision support tools for high-risk women and healthcare providers to increase chemoprevention informed choice and uptake: A retrospective translational science case study

## TL;DR

This case study explores how decision support tools for breast cancer risk assessment were developed and how they can improve informed choices about chemoprevention.

## Contribution

The study provides insights into the translational processes and challenges in developing patient-oriented cancer prevention tools.

## Key findings

- Funding and interdisciplinary collaboration were key facilitators in developing breast cancer risk tools.
- Mid-career support and technology costs were identified as major barriers to translation.
- Stakeholder engagement and team science efforts were crucial for successful translational outcomes.

## Abstract

Retrospective case studies are one approach to help identify processes underlying the translation of successful health interventions. This case study investigates the development of RealRisks and Breast Cancer Risk Navigation (BNAV), decision support tools for breast cancer risk assessment, and risk-stratified prevention. Following a recently developed protocol for retrospective translational science case studies, we examined the career trajectory of Dr Katherine Crew as she expanded from basic science to interdisciplinary, patient-oriented research in oncology and began collaboration with Dr Rita Kukafka, a public health informatician focused on communicating risk. Data collection methods included key informant interviews and examination of peer-reviewed publications, funded grants, and news articles associated with the research. Data were analyzed to identify key milestones in the development of RealRisks and BNAV and to elucidate facilitators and barriers to the translational process. Facilitators to translation included funding and infrastructure provided by a Clinical and Translational Science Award (CTSA), the creation of an interdisciplinary team, and broad support from stakeholders including patient advocacy groups. Barriers to translation included limited mid-career support, ongoing costs for technology, and the time required to establish interdisciplinary, team science efforts. The findings reported here can be used to inform ongoing efforts to develop a more robust science of translation.