Using Doctor-Patient Teams to Reduce Health Disparities

利用医患团队减少健康差距

• 批准号: 7100367
• 负责人: Louis A. Penner
• 金额: $ 19.41万
• 依托单位: WAYNE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7100367
• 关键词: African American; behavioral /social science research tag; bias; caucasian American; clinical research; education evaluation /planning; educational resource design /development; health behavior; health care model; health care policy; health care service evaluation; health disparity; health services research tag; human subject; medical education; outcomes research; patient care personnel attitude; patient care personnel relations; physicians; psychological tests; psychometrics; questionnaires; racial /ethnic difference; social cooperation; social psychology; training; videotape /videodisc

DESCRIPTION (provided by applicant): There is substantial evidence that in the U.S. the health status of members of racial/ethnic minorities is poorer than that of non-Hispanic whites. Reducing health disparities is a major priority of the federal government. There are many reasons for these health disparities, but a large research literature suggests that 1 major cause is that poorer health care is provided to members of racial/ethnic minorities than to non-Hispanic whites. Although there are multiple reasons for this poorer health care, a recent Institute of Medicine Committee concluded that the attitudes and beliefs of both doctors and patients may play a major role by affecting the climate of medical interactions involving minority group members. This study will empirically examine the validity of this and other conclusions of the IOM committee and explore the efficacy of an intervention that is designed to reduce the impact of patient-physician attitudes and beliefs on medical interactions. Therefore the major aims of this study are to : (1) examine how patient and physician attitudes and beliefs directly affect the climate of medical interactions involving minority group patients and compare this to interactions with majority group patients (2)determine how the climate of medical interactions affect health-related behaviors and health status of minority patients, (3) investigate the effects of an intervention designed to create doctor-patient teams that work together to solve the patient's medical problems. This intervention is based on a social psychological model of reducing intergroup bias. The intervention is intended to reduce the effects of preexisting physician and patient attitudes and beliefs that may adversely affect the climate of medical interactions. Producing this change should result in better health-related behaviors and eventually the health status of minority patients. The study will be conducted in a large urban primary care clinic that primarily serves African-American patients. In the first phase of the study, the associations between patient/physician attitudes/beliefs and (a) the climate of medical interactions and (b) subsequent health-related behaviors and health status will be examined In the second phase, a randomized field experiment will be used to test the effectiveness of the intervention. If successful, the study should provide an exportable means of improving communication between physicians and minority group patients and reducing disparities in health care.

描述（由申请人提供）：有大量证据表明，在美国，种族/族裔少数民族成员的健康状况比非西班牙裔白人差。减少健康差异是联邦政府的主要优先事项。这些健康差异有很多原因，但是大量的研究文献表明，有1个主要原因是，与非西班牙裔白人相比，向种族/族裔少数民族成员提供较差的医疗保健。尽管该医疗保健较差的原因有很多，但最近的一个医学研究所得出的结论是，医生和患者的态度和信念可能会通过影响涉及少数群体成员的医疗互动的气氛来发挥重要作用。这项研究将凭经验研究IOM委员会的这一结论和其他结论的有效性，并探讨旨在减少患者 - 医学态度和信念对医学互动的影响的干预措施的功效。因此，这项研究的主要目的是：（1）检查患者和医师的态度和信念如何直接影响涉及少数群体患者的医学互动的气氛，并将其与与多数组患者的互动进行比较（2）医疗相互作用的气候如何影响健康相关的行为和与少数族裔患者的健康状况有关，（3）对患者的效果（3）研究了培训的效果，以使工作人员组成了求助于工作人员的效果。该干预措施基于减少群体间偏见的社会心理模型。干预措施旨在减少可能对医疗相互作用的气候产生不利影响的医师和患者态度和信念的影响。产生这种变化应导致更好的健康相关行为，并最终导致少数族裔患者的健康状况。该研究将在主要为非裔美国人患者服务的大型城市初级保健诊所进行。在研究的第一阶段，患者/医师态度/信念与（a）医疗相互作用的气候以及（b）随后的与健康相关的行为和健康状况将在第二阶段进行检查，将在第二阶段进行检查，将使用随机现场实验来测试干预措施的有效性。如果成功，这项研究应提供可导出的方法，以改善医生与少数群体患者之间的沟通并减少医疗保健方面的差异。