Four Conversations Study

Program Leadership

Sophia Smith, PhD, MSW
Principal Investigator
Sophia Smith, PhD, MSW
Kelly Westbrook, MD
Kelly Westbrook, MD

About the Program

The Four Conversations™ program is for the metastatic breast cancer community. This online program assists with decision-making and care planning for those with advanced disease. It is designed to help you:

  • Learn skills to reduce stress, clarify your wishes, and feel empowered
  • Understand available treatment options, including palliative care and hospice
  • Share decision-making with your loved ones and healthcare providers
  • Transform fears into positive actions to improve quality-of-life and gain peace of mind

The Conversations

In each of the program’s four conversation modules, you will find brief instructional videos and printable documents to help guide you through the topics:

An Informative Conversation with Healthcare Professionals
Clarify how you want to be treated in all possible scenarios.


A Supportive Conversation with Family and Friends
Share your wishes, thoughts, reflections & love.


An Inspirational Conversation With or About Spirit
Explore your spiritual beliefs to make peace with life & death.


An Honest Conversation with Yourself
Clean up anything that needs to be resolved & plan some quality time.


You will also learn unique tools, take time for relaxation, and have access to live, online sessions with trained instructors who can help you process your feelings and get the answers you need. The course is broken down into bite-sized activities, so that you can do it all on your own schedule.

Who can participate?

You may qualify for this study if you:

  • Have been diagnosed with metastatic breast cancer (MBC), are a caregiver to a patient with MBC who is enrolled in this study, or are a MBC healthcare provider
  • Have Internet access through a computer/tablet
  • Are an adult (at least 18 years old)

What’s involved?

You will be asked to take part in the online program and complete surveys at three different time points. Participation lasts for two months, and you will receive monetary compensation for your time (as a patient or a healthcare provider). If you have questions or would like more information, please email us at or call 919.613.9444.


REGISTER: Patients & Caregivers

FOR: Healthcare Providers 

The Four Conversations study is being conducted by Duke University in partnership with Reimagine and is supported by the National Comprehensive Cancer Network and Pfizer Independent Grants for Learning and Change. We are a multidisciplinary team of researchers, oncologists, social workers and counselors. We work together to support the well-being of the cancer community. Study ID Number: Pro00070790