Improving Communications to Reduce Service Disparities

改善通信以减少服务差异

• 批准号: 7489506
• 负责人: MARIO CRUZ
• 金额: $ 16.33万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-12 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7489506
• 关键词: Address; Adherence; African American; Anti-Anxiety Agents; Anxiety; Appointment; Attitude; Audiotape; Award; Behavior; Behavior Therapy; Belief; Bipolar Disorder; Caring; Categories; Classification; Clinical; Cognitive; Communication; Communication Research; Coping Behavior; Count; Decision Making; Depressed mood; Depth; Development; Disease remission; Educational Intervention; Effectiveness; Emotional; Endogenous depression; Hearing; Individual; Intervention; Lifting; Link; Manuals; Measures; Mediating; Medical; Mental disorders; Mentored Clinical Oncology Award; Mentored Clinical Scientist Award; Mentored Patient-Oriented Research Career Development Award; Methods; Modeling; Moods; Nature; Neighborhoods; Numbers; Observational Study; Outcome; Outcome Measure; Outpatients; Patient Care; Patient Preferences; Patients; Pattern; Pharmaceutical Preparations; Pharmacotherapy; Positioning Attribute; Principal Investigator; Procedures; Process; Property; Provider; Psychiatric therapeutic procedure; Psychiatrist; Psychiatry; Psychometrics; Rate; Recommendation; Recording of previous events; Reporting; Research; Research Proposals; Research Training; Role; Roter; Seeds; Services; Social Problems; Stereotyping; Symptoms; System; Systems Analysis; Therapeutic; Time; Treatment outcome; Unemployment; Videotape; base; behavior influence; care preference; caucasian American; emotional distress; experience; improved; information gathering; preference; programs; psychosocial rehabilitation; skills; socioeconomics; suicidal

DESCRIPTION (provided by applicant): Black Americans with bipolar disorder receive poorer care than their White American counterparts. Racial bias and incongruence between psychiatrists' and patients' cultural explanations of illness may negatively influence psychiatrist-patient communications and contribute to disparities in care. This Mentored Patient-Oriented Research Career Development Award application (K-23), co-sponsored by Drs. Harold Alan Pincus and Debra Roter, is intended to provide an in-depth research and training experience to conduct systematic assessments of psychiatrists' communication skills. Research findings will be used to develop methods to improve psychiatrists' communication skills with Black Americans suffering from bipolar disorder. The award period will be used to develop qualitative and quantitative methods for systematically analyzing the influence of psychiatrists' communications on appointment outcomes. The specific aims are: (i) apply and refine recruitment procedures to overcome barriers to communications research in psychiatry; (ii) evaluate the psychometric properties of the Roter Interaction Analysis System (RIAS) for use in psychiatry; (iii) quantitatively describe psychiatrists' communications in the context of clinical care; (iv) using the RIAS to measure communications, link quantitative differences in psychiatrists' communications with White versus Black bipolar disorder patients to differences in appointment outcomes; and (v) qualitatively investigate patients' views and opinions about their interactions with psychiatrists, patients' preferences for care including psychiatrists' decision-making style, as well as patients' illness beliefs and coping behaviors that influence their adherence decisions. Two quantitative studies and one qualitative study are proposed. The Seed study is a cross-sectional and observational study that aims to address methodological and logistical questions about performing psychiatric communications research. In contrast to the Seed study, Study 2 is a longitudinal and observational study specifically addressing the aim of this K23 award research proposal- to assess the influence of psychiatrists' communications on outcomes disparities in care between Black and White bipolar patients. Generalized Linear Mixed Modeling will be used in the statistical analyses of both studies. Study 3 will explore Study 2 patients' views and opinions about the audio taped appointment, patients' care preferences, preferences for psychiatrists' decision-making styles, and patients' illness beliefs and coping behaviors that influence their adherence decisions. Linking psychiatrists' communications to care outcomes has implications for the development of quality improvement interventions that could impact the treatment of patients with severe mental disorders.

描述（由申请人提供）：患有躁郁症的黑人美国人接受的护理差，比其白人美国人同行。精神科医生和患者的疾病文化解释之间的种族偏见和不一致可能会对精神科医生的沟通产生负面影响，并导致护理差异。这是由DRS共同赞助的指导的以患者为导向的研究职业发展奖应用程序（K-23）。 Harold Alan Pincus和Debra Roter旨在提供深入的研究和培训经验，以对精神科医生的沟通技巧进行系统评估。研究发现将用于开发方法，以提高精神科医生与患有躁郁症的黑人美国人的沟通能力。该奖励期将用于开发定性和定量方法，以系统地分析精神科医生的沟通对任命结果的影响。具体目的是：（i）应用和完善招聘程序来克服精神病学传播研究的障碍； （ii）评估用于精神病学的转子相互作用分析系统（RIA）的心理测量特性； （iii）在临床护理的背景下进行定量描述精神科医生的沟通； （iv）使用RIA来衡量通信，将精神病医生与白人与黑色躁郁症患者的沟通中的定量差异联系起来，与任命结果的差异联系在一起； （v）定性地调查患者对他们与精神科医生的互动，患者对护理的偏好的看法和观点，包括精神科医生的决策方式，以及患者的疾病信念和应对影响其坚持决策的行为。提出了两项​​定量研究和一项定性研究。种子研究是一项横断面和观察性研究，旨在解决有关进行精神病学研究的方法论和后勤问题。与种子研究相反，研究2是一项纵向和观察性研究，专门针对该K23奖项研究建议的目的，以评估精神科医生对黑人和白人双极患者之间护理结果差异的影响。两项研究的统计分析将使用广义线性混合模型。研究3将探讨研究2名患者对音频录音的约会，患者的护理偏好，精神科医生决策风格的偏好以及患者疾病信念和影响其依从性决策的应对行为的看法和意见。将精神科医生的沟通与护理结果联系起来对发展质量改善干预措施的发展具有影响，这可能会影响严重精神疾病患者的治疗。