Dyadic Processes in the Patient-Provider Relationship

医患关系中的二元流程

• 批准号: 7754972
• 负责人: MALLORY O JOHNSON
• 金额: $ 15.08万
• 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/7754972
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Adherence; Area; California; Caring; Clinic; Clinical; Complement; Complex; Coupled; Data; Data Analyses; Data Collection; Development; Development Plans; Electronic Health Record; Electronic Mail; Electronics; Equilibrium; Foundations; Funding; Future; HIV; Health; Institutes; International; Intervention; Measures; Medical; Medical Informatics; Medicine; Mentors; Modeling; Outcome; Patient Preferences; Patients; Policies; Population; Positioning Attribute; Primary Health Care; Process; Provider; Public Health; Quality of life; Records; Research; Research Infrastructure; Research Personnel; Resources; Role; San Francisco; 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; patient oriented research; preference; professor; programs; psychosocial; public health relevance; research and development; satisfaction; shared decision making; social; theories; tool

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.

描述(由申请人提供)：Mallory Johnson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，他制定了一个蓬勃发展的多学科合作研究计划，专注于通过赋予患者权力来改善艾滋病毒治疗结果。K24的目的是申请必要的资金，以(1)在以患者为中心的研究(POR)中为早期职业临床医生和研究人员提供更广泛的指导，以及(2)将他目前的研究计划扩展到患者-提供者二联体的研究，这将通过将研究工具整合到电子健康记录(EHR)系统中来进行研究。约翰逊博士的实习生已经成为对进行POR感兴趣的研究临床医生。迫切需要更好地了解患者-提供者关系如何影响健康结果，以及如何扩大这些关系以改善结果。现有的许多关于这一主题的研究都局限于从单一的角度来研究患者和提供者之间的关系，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影响。了解如何从这两个方面衡量和分析这种关系，是制定有效干预模式的关键一步。此外，很明显，医疗信息学将成为美国和发展中国家医疗保健提供的越来越重要的基础。这项拟议的研究强调了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)在患者-提供者二元组上的上下文作用，并强调决策平衡偏好。因此，候选人寻求通过获得医疗信息学、提供商关系、二元数据分析和国际合作研究方面的专业知识来弥合这些领域，以保持在这个快速发展的领域的前沿。K24的支持将确保有足够的时间来追求他的研究的这一自然进展，同时保护时间来致力于指导POR中未来的临床医生研究人员。开发、研究和指导计划旨在相辅相成，在POR的新方向上创造指导和研究的协同效应。拟议的指导、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)以及加州大学旧金山分校的临床和翻译科学研究所(CTSI)。与公共卫生相关：(1)艾滋病毒携带者人数不断增加，他们的医疗和心理社会需求是多样和复杂的。初级保健提供者往往处于支持网络的中心，定位于优化健康结果。改善患者与提供者的关系是提高生存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，在发展循证公共卫生项目以改进实践和政策方面将缺乏创新和进展。