Patient-Provider Communication: CAM Beliefs, Attitudes and Practices

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DESCRIPTION (provided by applicant): Maureen George PhD, RN previously received F31 and F32 training grants from NCCAM to conduct qualitative work characterizing CAM use by African American adults with asthma. In review of her prior K23 submission, reviewers noted that the strengths of the proposal including "the strong candidate, excellent environment, and its investigation of minorities that may have high impact" In this resubmission, Dr. George adds mentors in CAM, instrumentation and statistical analysis to form a truly outstanding interdisciplinary mentoring team (Nursing, Medicine and Public Health). Her Sponsor's Statement reflects a detailed and thoughtful career development plan that Includes coursework as well as formal and informal mentoring in CAM-focused research design, implementation and analysis, instrument development, and communication. Hopkins provides the Candidate a fertile environment for mentoring, scholarship and research that will foster the Candidate's short-term goal of developing expertise in these areas and will facilitate the Candidate's long-term goal of becoming an independent CAM investigator. Given the unique challenges fading African American patients, an important first step in addressing health disparities may likely be strategies that foster mutual patient-provider understanding. Therefore, in this project we propose three inter-related projects. In Specific Aim 1 we propose to survey providers who deliver care to medically underserved populations regarding their personal CAM beliefs, attitudes and practices. In Specific Aim 2 we plan to develop, test and refine a CAM communication aid (instrument) to characterize patients' culturally-derived CAM beliefs, attitudes and practices. Lastly, we plan to test the clinical utility of the communication aid to 1) promote patient-provider discussions of CAM (communication), 2) foster mutual decision-making regarding treatment options (partnership), and 3) encourage disclosure of shared orientations to disease self-management (concordance). In so doing, we would provide the foundation for relationship-centered care and assist providers to acquire greater cultural competency. This may be especially important in minority populations who, compared to Caucasians and Asians, have high CAM use yet are less likely to inform their providers about CAM use, are less likely to experience adequate relationship-centered care and are more likely to experience profound health inequalities.