Improving Racial Equity in Clinical Decision Making about Access to Organ Transplant

改善器官移植临床决策中的种族平等

• 批准号: 10507407
• 负责人: Lisa M McElroy
• 金额: $ 13.17万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10507407
• 关键词: Attention; Black race; Cessation of life; Clinical; Cross-Sectional Studies; Data; Data Collection; Decision Making; Diagnostic tests; Disease; Educational Background; Electronic Health Record; Ethnic Origin; Evaluation; Focus Groups; Foundations; Funding; Future; Gender; Geography; Goals; Health system; Individual; Institutional Racism; Insurance Coverage; Intervention; Intervention Studies; Knowledge; Lead; Measures; Mediator of activation protein; Medicine; Mentors; Methods; Monitor; Nurses; Operative Surgical Procedures; Organ; Organ Transplantation; Outpatients; Patients; Persons; Phase; Plant Roots; Process; Quality of life; Race; Racial Equity; Research; Research Personnel; Social Work; Standardization; Surveys; System; Testing; Time; Training; Transplant Recipients; Transplantation; Transportation; United States; Waiting Lists; Work; acceptability and feasibility; black patient; clinical application; clinical decision-making; clinical practice; design; ethnic minority; improved; income insurance; meetings; multidisciplinary; optimal treatments; organ transplant recipient; patient screening; racial bias; racial disparity; racial minority; screening; skill acquisition; social health determinants; tool; transplant centers

PROJECT SUMMARY Organ transplantation is the optimal treatment for end stage organ disease and results in improved patient survival and quality of life. Black patients have rates of end stage organ disease nearly three times that of white patients, yet comprise only 20% of organ transplant recipients. The transplant selection process is not standardized across transplant centers and therefore decision making at each phase of the process is potentially vulnerable to institutional racism. Further, national transplant data collection and monitoring exclude the transplant selection process. The overall objective of this proposal is to identify, characterize, and intervene on inequities in organ transplant that occur due to health system processes which are vulnerable to interpersonal and institutional bias Our central hypothesis is that inadequate attention to equity promoting principles throughout each phase of the selection process are major contributors to inequitable access to organ transplant. This project will quantify racial inequities at each phase of the transplant selection process (screening, evaluation and committee decision making) using electronic health record data, characterize vulnerabilities in the transplant screening, evaluation and committee decision aming processes that contribute to overall inequities in access to transplant and design and pilot a toolkit to reduce inequities in the transplant screening, evaluation and committee decision making processes. This results of this project will elucidate the influence of institutional racism in transplant systems and processes on racial equity in access to transplant. The research and additional knowledge and skill development will form a strong foundation for the candidate’s transition to an independent investigator studying interventions to overcome institutionally biased practices which contribute to organ transplant inequities.

项目总结