Using Doctor-Patient Teams to Reduce Health Disparities

利用医患团队减少健康差距

基本信息

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
项目类别：
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

项目摘要

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，少数种族/族裔成员的健康状况比非西班牙裔白人更差。减少健康差距是联邦政府的首要任务。造成这些健康差异的原因有很多，但大量研究文献表明，一个主要原因是为少数种族/族裔成员提供的医疗保健比非西班牙裔白人更差。尽管造成医疗保健状况较差的原因有多种，但最近医学研究所委员会得出的结论是，医生和患者的态度和信仰可能会通过影响涉及少数群体成员的医疗互动氛围而发挥重要作用。本研究将实证检验 IOM 委员会的这一结论和其他结论的有效性，并探讨旨在减少医患态度和信念对医疗互动影响的干预措施的有效性。因此，本研究的主要目的是：（1）检查患者和医生的态度和信念如何直接影响涉及少数群体患者的医疗互动氛围，并将其与与多数群体患者的互动进行比较（2）确定医疗氛围如何影响少数群体患者的医疗互动氛围。相互作用影响少数族裔患者的健康相关行为和健康状况，（3）调查旨在创建共同解决患者医疗问题的医患团队的干预措施的效果。这种干预措施基于减少群体间偏见的社会心理模型。该干预措施旨在减少医生和患者现有态度和信念的影响，这些态度和信念可能对医疗互动的气氛产生不利影响。产生这种变化应该会带来更好的健康相关行为，并最终改善少数族裔患者的健康状况。该研究将在一家主要为非裔美国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，将检查患者/医生的态度/信念与（a）医疗互动氛围和（b）随后的健康相关行为和健康状况之间的关联。在第二阶段，将进行随机现场实验将用于测试干预措施的有效性。如果成功，该研究应提供一种可输出的方法，以改善医生和少数群体患者之间的沟通并减少医疗保健方面的差异。