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.

项目摘要/摘要 Wagahta Semere博士的长期职业目标是成为独立的临床评估者和领导者 开发和实施基于技术的沟通干预措施，以吸引潜水员 有效且安全的慢性病护理患者。她已经确定了吸引糖尿病的护理人员 管理是实现这一目标的关键问题。该建议描述了她全面的5年 培训计划和修改研究计划。提出的工作与AHRQ的数字部门保持一致 医疗保健研究使命，探讨不断发展的数字医疗保健生态系统如何最好地促进 医疗保健对患者及其家人的质量，安全性和有效性，并解决了多个AHRQ 优先人群（妇女，年长，种族/族裔少数民族，低收入和慢性病群体）。而博士 Semere在卫生服务研究方面具有强大的背景，该K08将在大数据中提供关键的培训 分析，定性和混合方法研究以及实施科学。慢性交流 导致共同理解的疾病护理与改善依从性，更好的疾病控制有关 和安全的结果。患者门户网站 - 允许患者方便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 - 提供理想的交流 在2型糖尿病（T2D）中获得共同理解和更好结果的平台。护理人员充当 代表患者的传递代理可以使患者与提供者互动的能力并扩大能力 通过SM平台。然而，代理在很大程度上仍然是尚未开发的资源，尤其是对于种族/族裔少数民族和 那些具有沟通障碍的人，他们可能会从代理参与中受益最大。提出的特定目的 （1）确定患者使用护理人员代理对安全消息传递（SM）的独立效果 T2D患者有或没有代理的T2D患者的临床结果，（2）比较SM的特征 T2D患者及其PCP之间的交换和不使用护理人员代理的患者以及 （3）在安全网环境中开发和测试飞行员干预，以吸引护理人员参与SM以促进 T2D患者有效的沟通和安全疾病管理。 Semere博士的Mentalship团队被领导 Schillinger博士，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，以及共同提供实用的科学家 补充她的教学培训的指导。此外，UCSF和 在扎克伯格旧金山将军的一般内科医学师内，将使她能够 实现拟议的项目目标。拟议的研究和培训完成后，Semere博士将 提交有竞争力的R级赠款申请，以测试几个随机试验中的飞行员干预措施 安全网诊所。她将具备为患者质量做出有影响力的贡献的技能和经验 通过以证据和以家庭为中心的沟通干预措施进行慢性病的安全。

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.