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.

项目摘要 包括艾滋病护理在内的多个疾病领域的证据表明， 沟通和关系大大改善了患者的健康结果。同样公认的是， 种族和少数民族--特别是非洲裔美国人--在参与社会活动方面的比率一直较低， 艾滋病毒护理，处方和坚持抗逆转录病毒药物，并有较高的发病率和死亡率。 有证据表明，这些差异可能部分来自关系中的种族/民族差异， 艾滋病毒临床医生和患者之间的沟通，这是一个潜在的补救来源的医疗保健 不平等我们项目的目标是开发创新的，有效的和可扩展的测量和分析 更好地理解患者-医生互动的方法，可以指导 采取干预措施，提高所提供的护理质量。 这一建议侧重于两个创新的特点，沟通：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， 语言顺应是会话参与者根据会话内容调整语言的过程。 另一个参与者的演讲风格。虽然目前有许多方法来衡量方面 在医患沟通中，迄今为止还没有研究探讨LSM和语言的作用。 住宿.两者都有希望成为产生更大社会/文化距离的潜在机制 低质量的关系和结果。因此，我们的具体目标是：（1）应用计算机化文本 分析工具，以临床医生-患者互动的成绩单，以产生新的措施LSM和语言 （2）评估LSM和语言的收敛和预测效度 适应艾滋病毒的结果，和（3）质量研究探索访问的例子与高和低LSM， 提供者语言风格维度与高和低关系质量相关。 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， 继续改善艾滋病毒护理质量和公平性。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，减少种族/民族差异， 艾滋病毒的结果，2）为一种新的传播分析方法提供了初步的有效性证据，3）扩大了 成本效益和医患互动的沟通分析研究的规模，以及4）提供 为艾滋病毒临床医生建立实时反馈系统提供指导，以随着时间的推移改善他们的互动。