DO TELL - Digitized Stories to Bridge the Gap Between Patient and Provider Perceptions of Disease Self-Management Challenges

DO TELL - 数字化故事弥合患者和提供者对疾病自我管理挑战的看法之间的差距

基本信息

批准号：
10328019
负责人：
Heather Ann Fritz
金额：
$ 37.59万
依托单位：
PACIFIC NORTHWEST UNIV/HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-15 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10328019
关键词：
DO TELL Digitized Stories Bridge

项目摘要

Project Summary Disparities in chronic condition self-management (CCSM) experienced by older African Americans stem, to a significant degree, from their complex challenges in CCSM and physicians' poor understanding of and/or empathy for those challenges. For physicians to assist older African Americans to optimize CCSM, they must have at least a better understanding of the complex and unique CCSM challenges faced by their patients. Patients' stories have been used increasingly to promote knowledge sharing, understanding, and reflective listening across diverse groups, as well as to foster successful behavior change among CCSM patients. However, patients' stories have not yet been used to promote physicians' understanding of the life circumstances of older African American patients who struggle with CCSM. To develop an effective story approach for large-scale use, however, we first need to better understand the experience of CCSM among older African Americans, how that experience can be translated into stories for medical education, and how such stories work or not to enhance physician understanding and improve care. Those steps are necessary to improve CCSM practice with older African American patients. The long-term goals of the proposed research are to (1) address these gaps in knowledge by creating and curating a library of validated digital CCSM stories of older African Americans that effectively enhance physicians' understanding and care interactions; and (2) sustain engagement in related research at the intersection of CCSM and minority aging by graduate and undergraduate occupational therapy students and faculty. The specific aims of the proposed R15 study are to (1) collect and analyze personal stories from older African Americans and transform them into digital narratives (videos) that reflect the most important CCSM challenges they face, and to (2) evaluate the concordance between story content and medical students' understanding of the stories. To address Aim 1 we will conduct focus groups (n = 6, 5-8 participants each) to collect older African Americans' narrative descriptions of CCSM challenges. We will analyze those narrative data to determine their core dimensions and rhetorical structure. That narrative content and structure will be validated by an expert panel (including older African Americans) and then translated into brief video stories enacted by older African Americans. To achieve Aim 2, we will use questionnaires and cognitive interviews with medical students (after video viewing) to determine their understanding of story content as well as factors that may explain variations in understanding. Aim 2 analysis will focus on examining rates of concordance between story and student understanding, and correlations between concordance and variables that could account for its variation, such as story dimensions, student ethnicity/race, and empathy scores. Open-ended responses on the questionnaire and cognitive interview data will be analyzed to further understand patterns in medical student understanding and their potential causes.

项目概要老年非裔美国人在慢性病自我管理 (CCSM) 方面的差异源于显着程度，来自他们在 CCSM 中的复杂挑战以及医生对和/或的理解不足对这些挑战的同理心。对于帮助老年非裔美国人优化 CCSM 的医生来说，他们必须至少更好地了解患者面临的复杂且独特的 CCSM 挑战。患者的故事越来越多地被用来促进知识共享、理解和反思倾听不同群体的声音，并促进 CCSM 患者成功的行为改变。然而，患者的故事尚未被用来促进医生对生命的理解与 CCSM 作斗争的老年非裔美国患者的情况。开发一个有效的故事大规模使用的方法，但是，我们首先需要更好地了解 CCSM 的经验年长的非裔美国人，如何将这种经历转化为医学教育的故事，以及如何这些故事是否能够增强医生的理解并改善护理。这些步骤是必要的改善老年非裔美国患者的 CCSM 实践。拟议研究的长期目标 (1) 通过创建和管理经过验证的数字 CCSM 故事库来解决这些知识差距老年非裔美国人有效增强医生的理解和护理互动；和（2）研究生和少数民族继续参与 CCSM 和少数民族老龄化交叉领域的相关研究本科职业治疗学生和教师。拟议的 R15 研究的具体目标是 (1) 收集和分析年长非裔美国人的个人故事，并将其转化为数字叙事（视频）反映他们面临的最重要的 CCSM 挑战，并 (2) 评估一致性故事内容和医学生对故事的理解之间的关系。为了实现目标 1，我们将进行焦点小组（n = 6，每个 5-8 名参与者）收集老年非裔美国人对 CCSM 的叙述性描述挑战。我们将分析这些叙事数据，以确定它们的核心维度和修辞结构。该叙述内容和结构将由专家小组（包括年长的非裔美国人）进行验证然后翻译成由年长的非裔美国人制作的简短视频故事。为了实现目标 2，我们将使用对医学生进行问卷调查和认知访谈（观看视频后）以确定他们的对故事内容的理解以及可能解释理解差异的因素。目标2分析将重点检查故事和学生理解之间的一致性以及相关性一致性和可以解释其变化的变量之间的关系，例如故事维度、学生种族/种族和同理心得分。对问卷和认知访谈数据的开放式回答将进行分析，以进一步了解医学生的理解模式及其潜在原因。