Disparities in Chronic Illness Care for Patients with Language Barriers

有语言障碍的患者在慢性病护理方面的差异

• 批准号: 8791542
• 负责人: Leo Sergio Morales
• 金额: $ 19.57万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8791542
• 关键词: Accident and Emergency department; Adherence; Adverse event; Affect; Applications Grants; Belief; California; Caring; Chinese People; Chronic; Chronic Disease; Chronically Ill; Clinical; Communication; Complex; Comprehension; Crowding; Data; Diabetes Mellitus; Diagnosis; Dose; Electronics; Emergency department visit; Future; Goals; Health; Health Services Research; Health system; Home environment; Hospitalization; Hyperlipidemia; Hypertension; Individual; Institution; Integrated Health Care Systems; Intervention; Journals; Koreans; Language; Limited English Proficiency; Link; Los Angeles; Mainstreaming; Mediating; Mediation; Medical; Modeling; Modification; Morbidity - disease rate; Outcome; Pacific Northwest; Patient Care; Patients; Peer Review; Pharmaceutical Preparations; Population; Provider; Publications; Quality of Care; Recommendation; Recording of previous events; Reporting; Research; Research Institute; Research Personnel; Risk; Screening for cancer; Statistical Methods; Surveys; System; Testing; United States; Universities; Vulnerable Populations; Washington; Wisconsin; base; common treatment; experience; foreign language; health care quality; improved; innovation; medication compliance; novel; public health relevance; satisfaction; skills; theories; treatment adherence; treatment program

PROJECT SUMMARY/ABSTRACT This project's overall goals are: 1) to investigate the impact of language barriers on medication adherence (following a prescribed medication program) and treatment intensification (increasing treatment) in patients with diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HL); and 2) to identify modifiable factors for targeting future interventions to enhance outcomes. Approximately 55 million people in the United States report speaking a foreign language at home and nearly 45% of these individuals (~25 million) report limited English proficiency (LEP). Patients with LEP are at increased risk for poor health care quality and poor health outcomes, but little research has looked at how language barriers affect treatment of common chronic conditions. The proposed project will be conducted at Group Health, a large, non-profit integrated health system in the Pacific Northwest with a long history of innovative health services research. A novel conceptual model of adherence to prescribed medications in LEP patients, based on previously developed adherence models, was created and used to guide selection of key factors to analyze. Data for the study will be collected from Group Health's extensive electronic health systems, augmented by surveys in Chinese, Korean, Spanish, Vietnamese, and English, given to 600 LEP patients. Data will be analyzed using advanced statistical methods. The Specific Aims of the project are: Aim 1. To evaluate how medication adherence, and treatment intensification, differ by LEP status in patients with DM, HTN, and HL; Aim 2. To characterize differences between patients by LEP status in patient, provider, and health system factors associated with medication adherence and treatment intensification, and to investigate the extent to which these factors explain differences identified in Aim 1 between LEP and non-LEP patients; and Aim 3. To identify modifiable patient, provider, and health system factors associated with medication adherence and treatment intensification in LEP populations. Findings from this project will go well beyond previous studies on LEP patients by identifying theory-driven modifiable patient-, provider- and system-levels factors associated with medication adherence and treatment intensification in subjects with limited English skills. The project brings together junior and senior researchers from Group Health, the University of Washington, UCLA, and the University of Wisconsin-Madison. We expect our findings to stimulate research on improving care for LEP patients, through publications in peer-reviewed journals and new grant applications that propose interventions to improve medication adherence and treatment intensification in patients facing language barriers.

项目摘要/摘要 该项目的总体目标是：1）调查语言障碍对药物依从性的影响 （遵循规定的药物计划）和患者的治疗强化（增加治疗） 糖尿病（DM），高血压（HTN）和高脂血症（HL）； 2）确定可修改因素 针对未来的干预措施以提高结果。美国约有5500万人 报告在家中说外语，这些人中有近45％（约2500万）有限公司 英语水平（LEP）。 LEP患者的医疗保健质量差和健康状况不佳的风险增加 结果，但很少研究研究语言障碍如何影响普通慢性的治疗 状况。拟议的项目将在集团健康公司进行，这是一个大型非营利性综合健康 西北太平洋的系统具有创新卫生服务研究的悠久历史。一种新颖的概念 基于先前发展的依从性，对LEP患者处方药的依从性模型 创建模型并用于指导关键因素进行分析。将收集研究数据 从集团健康的广泛电子卫生系统中，通过中文，韩国，西班牙语的调查增强 越南语和英语给了600名LEP患者。将使用高级统计方法分析数据。 该项目的具体目的是： 目的1。评估药物依从性和治疗强化的方式，因LEP状态而异 DM，HTN和HL的患者； 目标2。以患者，提供者和卫生系统的LEP状态来表征患者之间的差异 与药物依从性和治疗强化相关的因素，并研究 这些因素解释了在AIM 1和非LEP之间在AIM 1中鉴定出的差异的程度 患者;和 目的3。确定可修改的患者，提供者和卫生系统因素与药物相关的因素 LEP种群中的依从性和治疗强化。 该项目的发现将远远超出对LEP患者的先前研究，通过识别理论驱动 与药物依从性和治疗相关的可修改患者，提供者和系统级别的因素 英语技能有限的受试者的强化。该项目汇集了初级和高级研究人员 来自集团健康，华盛顿大学，加州大学洛杉矶分校和威斯康星大学麦迪逊分校。我们期望 我们的发现是通过同行评审的出版物来刺激改善LEP患者护理的研究 提出干预措施以改善药物依从性和治疗的新期刊和新赠款应用 面临语言障碍的患者的强化。

项目成果

Medication Related Self- efficacy among Linguistically Diverse Patients with Chronic Illnesses.

语言多样化的慢性病患者的药物相关自我效能。

• DOI: 10.1353/hpu.2018.0079
• 发表时间: 2018
• 期刊: Journal of health care for the poor and underserved
• 影响因子: 1.4
• 作者: Zhang,Ying;Solomon,Cam;Moreno,Gerardo;Chang,Eva;Lin,ElizabethH;Johnson,RonL;Berthoud,Heidi;Morales,LeoS
• 通讯作者: Morales,LeoS