Reducing Health Disparities at End of Life

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DESCRIPTION (provided by applicant): This project will expand interactive, web-based training materials designed to improve the effectiveness of communication between clinicians and patients from diverse populations, in order to improve the quality of health care at end of life. The aim of this study is to describe the effects of the web-based Culture & End of Life program on: Patient ratings of quality of communication, patient anxiety, and trust in the clinician. Additionally, content-based coding of clinician communication with patients will be assessed and cultural competence scores self-assessed by clinicians. Our interdisciplinary research team will recruit 40 primary care clinician and 1-3 patients per clinician. Primary care clinicians will be randomized to either the web-based Culture & End of Life program or to a wait list control. Patients will complete questionnaires assessing the clinicians' skill at having culturally congruent end-of-life discussions and have their interaction with their clinician audio-taped. This study will stimulate exploratory and developmental research that addresses a documented need in the current health care system: that of enhancing culturally congruent end of life communication. PUBLIC HEALTH RELEVANCE: This project will expand interactive, web-based training materials designed to improve the effectiveness of communication between clinicians and patients from diverse populations, in order to improve the quality of health care at end of life. This project will evaluate the effect of the web-based training for primary health clinicians on quality of end of life communication as assessed by patients and with content-based coding of clinician communication with patients.