Dyadic Processes in the Patient-Provider Relationship

医患关系中的二元流程

• 批准号: 8084143
• 负责人: MALLORY O JOHNSON
• 金额: $ 15.66万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8084143
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adherence; Applications Grants; Area; California; Caring; Clinic; Clinical; Clinical Sciences; Complement; Complex; Coupled; Data; Data Analyses; Data Collection; Development; Electronic Health Record; Electronic Mail; Electronics; Equilibrium; Foundations; Funding; Future; HIV; Health; Institutes; International; Intervention; Link; Manuscripts; Measures; Medical; Medical Informatics; Medicine; Mentors; Midcareer Investigator Award in Patient-Oriented Research; Modeling; Morbidity - disease rate; Outcome; Patient Preferences; Patients; Policies; Population; Positioning Attribute; Primary Health Care; Principal Investigator; Process; Provider; Public Health; Publishing; Quality of life; Records; Research; Research Infrastructure; Research Personnel; Resources; Role; San Francisco; Seeds; Side; Structure; System; Talents; Technology; Time; Training; Translational Research; Treatment outcome; United States; United States National Institutes of Health; Universities; base; career; career development; design; empowerment; evidence base; health care delivery; improved; innovation; interest; mortality; patient oriented research; preference; professor; programs; psychosocial; public health relevance; research and development; research study; satisfaction; shared decision making; social; theories; tool; treatment adherence

DESCRIPTION (provided by applicant): Dr. Mallory Johnson is Associate Professor in the Department of Medicine at the University of California San Francisco. Over the past decade, he has developed a thriving program of multi-disciplinary collaborative research focused on improving HIV treatment outcomes through patient empowerment. The purpose of this K24 is to request the necessary funding to (1) provide expanded mentoring of early career clinician- researchers in patient-oriented research (POR), and (2) extend his current research program to the study of patient-provider dyads, which will be studied through the integration of research tools into electronic health records (EHR) systems. Dr. Johnson's trainees have emerged as research clinicians interested in conducting POR. There is a critical need for a better understanding of how the patient-provider relationship influences health outcomes and how these relationships can be augmented to improve outcomes. Much of the existing research on this topic is limited to a single perspective of the patient-provider relationship, but seldom do studies attempt to understand the relationship and its implications simultaneously from the patients and providers. Understanding how to measure and analyze the relationship from these two sides is a critical step in developing an effective model for interventions. Further, it is clear that medical informatics will become an increasingly central base of healthcare delivery in the United States and developing world. The proposed research emphasizes the contextual role of EHRs and other technologies (such as email, patient access to online information portals, etc) on the patient-provider dyads, with an emphasis on decisional balance preferences. Therefore, the candidate seeks to bridge these areas through gaining expertise in medical informatics, provider relations, dyadic data analysis, and international collaborative research to remain on the cutting edge of this rapidly evolving field. The K24 support would insure sufficient time to pursue this natural progression of his research while protecting time to devote to mentoring future clinician investigators in POR. The plans for development, research, and mentoring were designed to complement each other and to create a synergistic effect of mentoring and research in a new direction of POR. The proposed mentoring, research, and career development activities actively leverage existing infrastructure, resources and training initiatives provided by NIH, including the candidate's active research program, the Center for AIDS Prevention Studies (CAPS), the Center for AIDS Research (CFAR), and the Clinical and Translational Science Institute (CTSI) at UCSF. PUBLIC HEALTH RELEVANCE: (1) There is a growing HIV+ population whose medical and psychosocial needs are diverse and complex. The primary care provider is often at the center of the support network positioned to optimize health outcomes. Improving the patient-provider relationship is a critical step toward improving survival and quality of life. (2) Without adequate mentoring to promote new scientific talent, there will be a lack of innovation and progress in the development of evidence-based public health programs to improve practice and policy.

简介（由申请人提供）：马洛里·约翰逊博士是加州大学旧金山分校医学系副教授。在过去的十年里，他开发了一个蓬勃发展的多学科合作研究项目，专注于通过患者赋权来改善艾滋病毒治疗结果。本K24的目的是请求必要的资金，以(1)为早期职业临床医生-研究人员提供面向患者的研究（POR）的扩展指导，以及(2)将他目前的研究项目扩展到患者-提供者的研究，这将通过将研究工具集成到电子健康记录（EHR）系统中进行研究。约翰逊博士的学员已经成为对POR感兴趣的临床研究人员。迫切需要更好地了解医患关系如何影响健康结果，以及如何加强这些关系以改善结果。关于这一主题的现有研究大多局限于患者-提供者关系的单一视角，但很少有研究试图同时从患者和提供者的角度来理解这种关系及其含义。了解如何从这两个方面衡量和分析关系是开发有效干预模式的关键一步。此外，很明显，医学信息学将成为美国和发展中国家医疗保健服务日益重要的基础。拟议的研究强调电子病历和其他技术（如电子邮件，患者访问在线信息门户等）对患者-提供者二元关系的上下文作用，重点是决策平衡偏好。因此，候选人寻求通过获得医学信息学、提供者关系、二元数据分析和国际合作研究方面的专业知识来连接这些领域，以保持在这一快速发展领域的前沿。K24的支持将确保他有足够的时间来追求研究的自然进展，同时保护时间来指导未来的临床研究人员在POR。开发、研究和指导的计划被设计成相互补充，并在新的扶贫开发方向上创造指导和研究的协同效应。建议的指导、研究和职业发展活动积极利用NIH提供的现有基础设施、资源和培训计划，包括候选人的积极研究计划、艾滋病预防研究中心（CAPS）、艾滋病研究中心（CFAR）和UCSF的临床和转化科学研究所（CTSI）。公共卫生相关性：(1)艾滋病毒阳性人群不断增加，其医疗和心理社会需求多样而复杂。初级保健提供者通常处于支持网络的中心，定位于优化健康结果。改善医患关系是提高生存率和生活质量的关键一步。(2)如果没有足够的指导来促进新的科学人才，那么在以证据为基础的公共卫生项目的发展中，将缺乏创新和进步，以改善实践和政策。