Promoting Safety by Engaging Diverse Diabetes Patients and their Caregivers in Secure Messaging

通过让不同的糖尿病患者及其护理人员参与安全消息传递来提高安全性

• 批准号: 10668293
• 负责人: Wagahta Semere
• 金额: $ 14.77万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668293
• 关键词: Promoting; Safety; Engaging; Diverse; Diabetes

Project Summary/Abstract Dr. Wagahta Semere’s long-term career goal is to be an independent clinician-investigator and leader in developing and implementing technology-based communication interventions to engage caregivers for diverse patients in effective and safe chronic disease care. She has identified engaging caregivers in diabetes management as a critical issue to achieve this goal. This proposal describes her comprehensive 5-year program of training and mentored research. The work proposed is aligned with AHRQ’s Division of Digital Healthcare Research mission to explore how the evolving digital healthcare ecosystem can best advance the quality, safety, and effectiveness of healthcare for patients and their families and addresses several AHRQ Priority Populations (women, elderly, racial/ethnic minorities, low income, and chronic illness groups). While Dr. Semere has a strong background in health services research, this K08 will provide key training in large data analytics, qualitative and mixed methods research, and implementation science. Communication in chronic illness care that leads to shared understanding has been linked to improved adherence, better disease control, and safer outcomes. Patient portals—systems that allow patients convenient access to their health information online and the ability to exchange secure messages (SM) with providers—offer an ideal communication platform to achieve shared understanding and better outcomes in type 2 diabetes (T2D). Caregivers acting as proxies, messaging on patients’ behalf, can enable and expand the ability of patients to engage with providers via SM platforms. Yet, proxies largely remain an untapped resource, especially for racial/ethnic minorities and those with communication barriers, who may benefit most from proxy involvement. The proposed specific aims are (1) to determine the independent effect of patient use of caregiver proxies for secure messaging (SM) on clinical outcomes among T2D patients with and without proxies, (2) to compare the characteristics of SM exchange between T2D patients and their PCPs among patients who do and do not use caregiver proxies, and (3) to develop and test a pilot intervention in the safety-net setting to engage caregivers in SM to promote effective communication and safe disease management for T2D patients. Dr. Semere’s mentorship team is led by Dr. Schillinger and includes nationally recognized health services researchers, communication scientists, qualitative and mixed methods experts, and implementation scientists who together will provide practical guidance to complement her didactic training. In addition, the supportive research environments at UCSF and within the Division of General Internal Medicine at Zuckerberg San Francisco General, will enable her to achieve the proposed project aims. Upon completion of the proposed research and training, Dr. Semere will submit a competitive R-level grant application to test the pilot intervention in a randomized trial across several safety-net clinics. She will possess the skills and experience to make impactful contributions to patient quality and safety in chronic disease through evidence-based and family-centered communication interventions.

项目概要/摘要 Wagahta Semere 博士的长期职业目标是成为一名独立的临床研究者和领导者 制定和实施基于技术的沟通干预措施，让护理人员参与不同的工作 患者获得有效且安全的慢性病护理。她确定了糖尿病护理人员的参与 管理作为实现这一目标的关键问题。该提案描述了她 5 年的综合经历 培训和指导研究计划。拟议的工作与 AHRQ 的数字部门保持一致 医疗保健研究的使命是探索不断发展的数字医疗保健生态系统如何最好地推动 患者及其家人的医疗保健质量、安全性和有效性，并解决了几个 AHRQ 优先人群（女性、老年人、少数种族/族裔、低收入群体和慢性病群体）。虽然博士。 Semere拥有深厚的健康服务研究背景，本次K08将提供大数据方面的重点培训 分析、定性和混合方法研究以及实施科学。慢性病中的沟通 导致共同理解的疾病护理与提高依从性、更好的疾病控制、 和更安全的结果。患者门户——允许患者方便地访问其健康信息的系统 在线以及与提供商交换安全消息 (SM) 的能力——提供理想的通信 平台以在 2 型糖尿病 (T2D) 方面达成共识并取得更好的结果。护理人员充当 代理，代表患者发送消息，可以启用并扩展患者与提供者互动的能力 通过SM平台。然而，代理在很大程度上仍然是一种未开发的资源，特别是对于少数种族/族裔和 那些有沟通障碍的人可能会从代理参与中受益最多。拟议的具体目标 (1) 确定患者使用护理人员代理进行安全消息传递 (SM) 的独立影响 使用和不使用代理的 T2D 患者的临床结果，(2) 比较 SM 的特征 使用和不使用护理人员代理的患者之间的 T2D 患者及其 PCP 之间的交流，以及 (3) 制定并测试安全网环境中的试点干预措施，让护理人员参与 SM，以促进 T2D 患者的有效沟通和安全疾病管理。 Semere博士领导的导师团队 由 Schillinger 博士撰写，包括国家认可的卫生服务研究人员、传播科学家、 定性和混合方法专家以及实施科学家将共同提供实用的 指导以补充她的教学培训。此外，加州大学旧金山分校的支持性研究环境和 在扎克伯格旧金山总医院的普通内科部门工作，将使她能够 实现拟议的项目目标。完成拟议的研究和培训后，塞米尔博士将 提交竞争性 R 级拨款申请，以在多项随机试验中测试试点干预 安全网诊所。她将拥有为患者质量做出有影响力的贡献的技能和经验 通过基于证据和以家庭为中心的沟通干预措施来提高慢性病的安全性。

项目成果

Family caregivers navigating the health care system: Evolving roles during the COVID-19 pandemic.

• DOI: 10.1037/fsh0000688
• 发表时间: 2022-06
• 期刊: FAMILIES SYSTEMS & HEALTH
• 影响因子: 1.3
• 作者: Semere, Wagahta;Makaroun, Lena K.;Beach, Scott;Schillinger, Dean;Rosland, Ann-Marie
• 通讯作者: Rosland, Ann-Marie

"We need to bring them out from the shadows:" A qualitative study of safety net physician leaders' perspectives on caregivers.

• DOI: 10.1016/j.pec.2021.10.019
• 发表时间: 2022-06
• 期刊: PATIENT EDUCATION AND COUNSELING
• 影响因子: 3.5
• 作者: Semere, Wagahta;Cemballi, Anupama G.;Schillinger, Dean;Casillas, Alejandra;Lemberg, Miya;Lyles, Courtney R.
• 通讯作者: Lyles, Courtney R.