Racial and Ethnic Disparities in Clinician-Caregiver Communication During Inpatient Pediatric Family-Centered Rounds

点击翻译按钮获取中文摘要

ABSTRACT—Overall Racial and ethnic health disparities are ubiquitous, lead to excess morbidity and mortality, and are associated with substantial healthcare costs. These disparities are present even among those with similar access to care, suggesting that providers and health systems (as indicated in the NIMHD framework) are important contributors to health disparities. Yet most studies of interventions to reduce disparities have focused on changing patient behavior and knowledge, leaving substantial gaps in the evidence base of effective interventions to reduce disparities in healthcare delivery. In this application, we propose The Duke Center for REsearch to AdvanCe Healthcare Equity. REACH Equity will address gaps in current disparities' research by focusing on the quality of healthcare delivery in the clinical encounter—a setting where racial and ethnic disparities in care are well-documented. The overall theme of REACH Equity is to: develop and test interventions that reduce racial and ethnic disparities in health by improving the quality of patient-centered care in the clinical encounter through better provider communication, high quality interpersonal processes of care, and shared decision making. Rather than focusing on a single disease, REACH Equity will support research which is applicable to and can be replicated across diagnoses, settings of care, stages of illness, and throughout the life course. The Specific Aims of REACH Equity are to: (1) Create an umbrella for the integration of transdisciplinary health disparities research that extends across the campus and health system. (2) Catalyze and support a program of relevant, rigorous, reproducible research related to the Center's theme. (3) Develop the next generation of transdisciplinary health disparities investigators through a research education and training pipeline program which includes undergraduates, medical and graduate students, postdoctoral trainees, and early-career faculty. (4) Diversify the health disparities research workforce by intentionally identifying, mentoring, and developing underrepresented minority (URM) investigators, leaders, and role models. (5) Develop reciprocal partnerships which facilitate community and stakeholder engagement in the Center and ensure widespread dissemination of research findings. REACH Equity will leverage the vast resources of a large health system, nationally ranked training programs, research-intensive academic medical center, and community stakeholder partnerships, to advance scientific knowledge which will have a real-world impact on racial and ethnic disparities in patient-centered care and ultimately health outcomes. The Center will also address national priorities in training health disparities investigators and increasing diversity in the research workforce.