Doctor-Patient Communication about Colorectal Cancer Screening and Health Dispari

描述（由申请人提供）：这个职业发展应用的长期目标是启动一个独立的研究计划，在癌症预防和控制与特定的专业知识，在改善临床医生与患者的沟通服务不足的人群。最近的注意力已经支付的重要作用，沟通的临床遭遇，其对病人的结果。总的来说，这项研究没有在服务不足的人群中进行，尽管服务不足人群中的患者对他们的临床医生有更高的不信任程度，报告对就诊的满意度较低，依从性较差。鉴于进口的临床医生与患者的沟通和新出现的证据干预措施的有效性，以改善临床医生与患者的沟通，一个更复杂的理解医生和服务不足的患者之间的沟通及其对患者的影响是必要的。该职业奖的学习目标包括：1）增加对影响健康差异的因素的理解，以便更好地计划研究和解释结果; 2）获得癌症流行病学的工作知识，以告知我对结果测量的选择; 3）学习制定社区干预措施的核心原则，以改变健康行为; 4）通过参加会议和建立网络与研究人员建立健康差异的工作关系; 5）探索供应商和低收入少数民族患者之间的沟通，重点是坚持CRC筛查; 6）采用社区参与式方法，获取利益相关者对以医生为中心的沟通培训干预措施的可行性和可接受性的意见。结直肠癌筛查将提供这种应用的研究范例，因为种族、收入和教育在筛查和癌症发病率方面存在差异。深入研究医患讨论癌症筛查的影响，将为探索服务不足人群中临床医生与患者沟通所面临的独特挑战提供机会。最终，这项工作将导致制定干预措施，以改善这些环境中的沟通。通过与导师和多学科同事在资源充足的机构环境，正式的课程和教育活动以及拟议的研究中进行密集的互动，该奖项将为我作为医患沟通和健康差异的独立研究员做好准备。

DESCRIPTION (provided by applicant): The long-term goal of this career development application is to launch an independent research program in cancer prevention and control with specific expertise in improving clinician-patient communication in underserved populations. Recent attention has been paid to the vital role of communication in clinical encounters and its effect on patient outcomes. In general, this research has not taken place with underserved populations, although patients in underserved populations have higher levels of mistrust of their clinicians, report lower levels of satisfaction with the encounter, and have poorer adherence. Given the import of clinician-patient communication and the emerging evidence about the effectiveness of interventions to improve clinician-patient communication, a more sophisticated understanding of communication between doctors and underserved patients and its impact on patient outcomes is required. Learning objectives for this career award include: 1) gain an increased understanding of the factors influencing health disparities in order to better plan studies and interpret results; 2) obtain a working knowledge of cancer epidemiology to inform my selection of outcome measures; 3) learn core principles for developing community interventions to change health behavior; 4) develop working relationships with researchers in health disparities through conference attendance and networking; 5) explore the communication between providers and low-income, minority patients with a focus on adherence to CRC screening; and 6) use a community-based participatory approach to obtain stakeholders' opinions about feasibility and acceptability of doctor-focused communication training interventions. Colorectal cancer screening will provide the paradigm for study in this application because of the disparities in both screening and cancer incidence by race, income, and education. The in-depth study of the effect of doctor-patient discussions about cancer screening will provide the opportunity to explore unique challenges faced in clinician-patient communication in underserved populations. Ultimately, this work will lead to the development of interventions to improve communication in these settings. Through intensive interaction with mentors and multi- disciplinary colleagues within a well-resourced institutional environment, formal coursework and educational activities, and the proposed research, this award will prepare me for a career as an independent researcher in doctor-patient communication and health disparities.