Developing Novel Linguistic Analytic Methods to Optimize Relationship Quality and Equity in HIV Care

开发新的语言分析方法以优化艾滋病毒护理中的关系质量和公平性

• 批准号: 10252171
• 负责人: MARY CATHERINE BEACH
• 金额: $ 24.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10252171
• 关键词: Address; African American; Anti-Retroviral Agents; Appointment; Area; Caring; Clinical; Code; Communication; Data; Dimensions; Disease; Feedback; Funding; Goals; HIV; Health; Healthcare; Language; Linguistics; Manual Communication; Manuals; Measurement; Measures; Medical; Methods; Morbidity - disease rate; Outcome; Participant; Patients; Perception; Persons; Pharmaceutical Preparations; Physicians; Process; Provider; Quality of Care; RNA; Race; Relationship-Building; Research; Role; Serum; Source; Specificity; Speech; Structure; System; Text; Time; Training Programs; Transcript; Translations; Viral Load result; Visit; Vocabulary; Vulnerable Populations; analytical method; antiretroviral therapy; archive data; archived data; black patient; communication behavior; computerized; cost; cost effectiveness; cultural competence; design; ethnic difference; ethnic minority population; improved; innovation; mortality; novel; patient-clinician communication; programs; racial and ethnic; racial and ethnic disparities; racial minority; skills; skills training; social; therapy development; tool

Project Summary Evidence across multiple disease areas including HIV care demonstrates that higher quality patient-clinician communication and relationships substantially improves patient health outcomes. It is also well-established that racial and ethnic minorities - African Americans in particular - have consistently lower rates of being engaged in HIV care, be prescribed and adhere to antiretroviral medications, and have higher morbidity and mortality. Evidence suggests that these disparities may rise in part from racial/ethnic differences in relationships and communication between HIV clinicians and patients, which are a potentially remediable source of healthcare inequities. The goal of our project is to develop innovative, valid and scalable measurement and analytic approaches for better understanding of patient-physician interactions that can guide development of interventions to improve the quality of care delivered. This proposal focuses on two innovative features of communication: linguistic style matching (LSM) and linguistic accommodation. LSM is the tendency of participants to use a common vocabulary and speech structure, while linguistic accommodation is the process by which participants in a conversation adjust their language according to the speech style of the other participant. Although there are currently many methods for measuring aspects of patient-clinician communication, no studies to date have explored the role of LSM and linguistic accommodation. Both hold promise as potential mechanisms by which greater social/cultural distance can result in lower quality relationships and outcomes. Accordingly, our specific aims are: (1) Apply computerized text analysis tools to transcripts of clinician-patient interactions to generate novel measures of LSM and linguistic accommodation in HIV care, (2) Evaluate the convergent and predictive validity of LSM and linguistic accommodation to HIV outcomes, and (3) Qualitatively explore examples of visits with high and low LSM and with provider linguistic style dimensions associated with high and low relationship quality. A better understanding of the dynamics of physician and patient interaction in HIV care is necessary to inform continued improvements in HIV care quality and equity. The innovative approach outlined here can: 1) elucidate mechanisms by which HIV clinicians can communicate more effectively and reduce racial/ethnic disparities in HIV outcomes, 2) provide initial validity evidence for a novel communication analytic methods, 3) expand the cost-effectiveness and scale of communication analysis studies of physician-patient interaction, and 4) provide guidance on building real-time feedback systems for HIV clinicians to improve their interactions over time.

项目概要 包括艾滋病毒护理在内的多个疾病领域的证据表明，更高质量的患者临床医生 沟通和关系显着改善患者的健康结果。这也是公认的 少数种族和族裔——尤其是非裔美国人——的参与率一直较低 艾滋病毒护理、处方并坚持抗逆转录病毒药物治疗，发病率和死亡率较高。 有证据表明，这些差异可能部分源于人际关系和民族方面的差异。 HIV 临床医生和患者之间的沟通，这是潜在的可补救的医疗保健来源 不平等。我们项目的目标是开发创新、有效和可扩展的测量和分析方法 更好地理解患者与医生互动的方法，可以指导开发 旨在提高护理质量的干预措施。 该提案重点关注沟通的两个创新特征：语言风格匹配（LSM）和语言 住宿。 LSM 是参与者使用共同词汇和言语结构的倾向，而 语言适应是对话参与者根据情况调整语言的过程 其他参与者的演讲风格。虽然目前衡量方面的方法有很多 就医患沟通而言，迄今为止还没有研究探讨 LSM 和语言的作用 住宿。两者都有望成为导致更大社会/文化距离的潜在机制 处于较低质量的关系和结果中。因此，我们的具体目标是：（1）应用计算机化文本 分析工具记录临床医生与患者的互动，以生成 LSM 和语言的新测量方法 HIV 护理中的适应，(2) 评估 LSM 和语言的收敛和预测有效性 (3) 定性探索 LSM 高和低的就诊实例 与高低关系质量相关的提供者语言风格维度。 有必要更好地了解艾滋病毒护理中医生和患者互动的动态，以便为患者提供信息 艾滋病毒护理质量和公平性持续改善。这里概述的创新方法可以：1）阐明 艾滋病毒临床医生可以更有效地沟通并减少种族/民族差异的机制 HIV 结果，2) 为新型沟通分析方法提供初步有效性证据，3) 扩展 医患互动的沟通分析研究的成本效益和规模，4) 提供 为艾滋病毒临床医生建立实时反馈系统以改善他们的互动的指南。