Understanding and addressing structural racism and its impact on the quality of end-of-life care in older Black adults
理解和解决结构性种族主义及其对老年黑人临终关怀质量的影响
基本信息
- 批准号:10704102
- 负责人:
- 金额:$ 24.3万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-15 至 2027-06-30
- 项目状态:未结题
- 来源:
- 关键词:AccountabilityAddressAdultAlabamaAmericanAreaAsian AmericansAttitudeAwardBlack AmericanBlack raceCaringClinicalClinical TrialsCommunitiesCrowsDevelopment PlansDiscriminationEconomicsEducationElderlyEmpathyEmploymentEthicistsFaceFailureFamily memberFutureGeriatricsGoalsHealthHealth Services AccessibilityHealth systemHealthcareHospital AdministratorsHospitalistsHospitalsHousingIncentivesIndividualInequityInstitutionInstitutional RacismInternationalInterventionIntervention StudiesInterviewKnowledgeLeadershipLearningLife Cycle StagesLife ExperienceMethodsMissionNational Institute on AgingOutcomePain managementPalliative CarePathway interactionsPerceptionPersonal SatisfactionPersonsPolicePoliciesPublic HealthRacial EquityRecording of previous eventsResearchResearch MethodologyResearch PersonnelSan FranciscoScholarshipShapesSiteSocial EnvironmentSocial JusticeStructural RacismStructureSystemTestingTrainingUniversitiesVariantWomanWorkacceptability and feasibilityanti-racismcareer developmentclinical carecohortcommunity based participatory researchcommunity-level factordesigndriving forceeffectiveness/implementation hybridend of lifeend of life careexperiencefeasibility testinghealth care disparityhealth equityhuman centered designimplementation scienceimprovedinnovationlensmaltreatmentmembermulti-component interventionmultidisciplinarymutual learningneglectnovelpragmatic trialpreferenceprotocol developmentracial disparityracismskillssociologisttheoriestherapy developmenttool
项目摘要
PROJECT SUMMARY/ABSTRACT
Black Americans are less likely to receive quality end-of-life (EOL) care in part due to racial disparities in goal-
concordant care, inadequate pain treatment, and reduced palliative care access, among others. Despite dec-
ades of research documenting racial disparities in EOL care, there has been little progress in rectifying these
inequities. This is in part due to a failure to recognize structural racism (e.g. anti-Black discrimination and mis-
treatment created and reinforced by multiple societal institutions including education, employment, housing,
policing, and healthcare) as a root cause of racial disparities. There is a critical research gap in our under-
standing of how structural racism influences racial disparities in the receipt of quality EOL care and
interventions to address them. The objective of this Beeson proposal is to understand and address structural
racism and its influence on the receipt of quality EOL care in older Black adults. This project's career develop-
ment plan will provide Dr. Elizabeth Dzeng with skills and knowledge in CBPR, implementation sciences,
clinical trials, leadership in community academic partnerships, structural racism scholarship, geriatrics, and life
course perspectives. A Beeson award will enable her to become an independent investigator in understanding
and addressing structural racism in EOL care using CBPR and support her long-term goal to become an inter-
national research leader in health and racial equity in geriatric palliative care. This study will be conducted at
two sites, the San Francisco Bay Area and Birmingham, Alabama, to provide institutional and local variation to
enable understanding of the influence of local and institutional histories, policies, and cultures on healthcare.
Dr. Dzeng has already been establishing community connections and developing her Community Advisory
Board. The first aim of this proposal seeks to understand the lived experiences of structural racism that older
Black adults face and how they perceive it influences EOL care. The project's second aim is to understand how
structural racism at the institutional and community level drives inequities in the provision of quality EOL care
and the barriers and facilitators to institutional change. The third aim is to design, pilot, and determine the ac-
ceptability and feasibility of an intervention that adapts a multi-component pathway to hospitals to mitigate
structural racism in EOL care. This study is highly innovative because it would be the first study to systemati-
cally examine and address structural racism in geriatric palliative care using life course perspectives and
CBPR. It uses novel interview methods and CBPR to examine the multi-level factors that contribute to racial
inequities in EOL care at a systemic level. This study is significant because it will develop understand at a
deeper level of how structural racism impacts end-of-life care and address structural racism through a multi-
disciplinary multi-component intervention. This study will inform a future R01 application for a multi-center hy-
brid effectiveness-implementation pragmatic trial of an institution-level anti-racism protocol development
intervention to mitigate structural racism in EOL care.
项目摘要/摘要
美国黑人接受高质量临终关怀的可能性较低,部分原因是在Goal-
和谐的护理,不充分的疼痛治疗,以及减少姑息治疗的机会等。尽管12月-
尽管有大量研究记录了EOL护理中的种族差异,但在纠正这些差异方面进展甚微
不平等。这在一定程度上是由于未能认识到结构性种族主义(例如,反黑人歧视和错误--
由多种社会机构创造和加强的待遇,包括教育、就业、住房、
警察和医疗保健)是造成种族差异的根本原因。我们在研究方面有一个关键的缺口-
结构性种族主义如何影响获得高质量的终生保健和
解决这些问题的干预措施。此Beeson提案的目标是理解和解决结构
种族主义及其对老年黑人接受高质量EOL护理的影响。这个项目的事业发展-
项目计划将为伊丽莎白·曾博士提供CBPR、实施科学、
临床试验、社区学术伙伴关系中的领导、结构性种族主义奖学金、老年病学和生活
课程视角。Beeson奖将使她成为一名独立的调查员
并使用CBPR解决EOL护理中的结构性种族主义问题,并支持她成为一名
在老年姑息治疗方面的健康和种族平等方面的国家研究领导者。这项研究将在
两个地点,旧金山湾区和阿拉巴马州伯明翰,提供机构和当地变化
了解当地和机构的历史、政策和文化对医疗保健的影响。
曾博士已经建立了社区联系,并发展了她的社区咨询
冲浪板。这项提议的第一个目的是试图理解结构性种族主义的活着经历
黑人成年人的脸以及他们对此的看法如何影响EOL护理。该项目的第二个目标是了解如何
机构和社区一级的结构性种族主义导致在提供优质的EOL护理方面存在不平等现象
以及体制变革的障碍和推动者。第三个目标是设计、试验和确定AC-
适应医院多组分途径的干预措施的可接受性和可行性
EOL护理中的结构性种族主义。这项研究具有很高的创新性,因为它将是第一次系统地研究。
Cally审查和解决结构性种族主义在老年姑息护理中使用生命过程的观点和
CBPR。它使用新的访谈方法和CBPR来检查导致种族问题的多层面因素
系统性EOL护理中的不平等现象。这项研究具有重要意义,因为它将在一段时间内加深对
更深层次地了解结构性种族主义如何影响临终关怀,并通过多个
学科多成分干预。这项研究将为未来R01申请多中心HY-
BRID有效性--机构一级反种族主义议定书制定的执行务实试验
干预措施,以减轻EOL护理中的结构性种族主义。
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Elizabeth Dzeng其他文献
Elizabeth Dzeng的其他文献
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{{ truncateString('Elizabeth Dzeng', 18)}}的其他基金
Understanding and addressing structural racism and its impact on the quality of end-of-life care in older Black adults
理解和解决结构性种族主义及其对老年黑人临终关怀质量的影响
- 批准号:
10513224 - 财政年份:2022
- 资助金额:
$ 24.3万 - 项目类别:
Identifying contributing factors to burdensome ICU treatments in older adults with Alzheimer's disease and related dementias in the United States and United Kingdom
确定美国和英国患有阿尔茨海默病和相关痴呆症的老年人在 ICU 接受繁重治疗的影响因素
- 批准号:
9751155 - 财政年份:2018
- 资助金额:
$ 24.3万 - 项目类别:
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