Improving Asthma Outcomes through Cultural Competence Training for Physicians

通过医生文化能力培训改善哮喘治疗结果

基本信息

批准号：
8013012
负责人：
NOREEN M CLARK
金额：
$ 74.83万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-02-01 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8013012
关键词：
Accounting Address African American Americas Asthma Belief Caring Child Child health care Childhood Clinical Communication Control Groups Counseling Cultural Diversity Data Dimensions Education Educational Curriculum Ethnic group Fostering Future General Population Goals Guidelines Health Health behavior Healthcare Healthcare Systems High Prevalence Hispanics Institution Intervention Latino Literature Medical Records Mink Minority New York Outcome Parents Patients Performance Physicians Population Prevention program Provider Puerto Rican Quality of life Randomized Clinical Trials Reporting Research Resources Stereotyping Surveys Symptoms Techniques Telephone Interviews Therapeutic Training Training Programs Uncertainty United States Work clinical practice continuing medical education cultural competence design expectation experience improved medical schools patient population programs racial and ethnic response satisfaction skills social

项目摘要

DESCRIPTION (provided by applicant): Massive effort and resources are expended every year on cultural competence training for physicians. Such training is part of the curriculum of virtually every medical school in America and a focus of continuing medical education nationwide. However, no rigorous study has assessed whether cultural competence training for physicians results in better health outcomes for their patients. This application is in response to PA-08-083. We propose to conduct a randomized clinical trial involving 90 clinicians in Atlanta, Georgia and New York, New York and 1192 of their African American and Puerto Rican pediatric patients with asthma. Both groups of patients have been shown to be among those with the highest prevalence of asthma and problems associated with the condition. Two interventions will be studied. First is a proven program, Physician Asthma Care Education (PACE), for enhancing physicians' clinical therapeutics, communication, and counseling skills shown to produce positive outcomes for the general population of children with asthma. The second is a version of the program designed to enhance the cultural competence of the clinician, specifically, in working with the target patient population (PACE PLUS). The proposed study will answer two questions: 1) Does cultural competence training (PACE PLUS) produce better outcomes for minority patients, specifically African American and Puerto Rican children and their parents than a general communication training program (PACE)? 2) Compared to a control group, is the PACE program, already shown to be effective with the general population of patients, effective when used with minority patients, specifically African American and Puerto Rican children and their parents. The study hypothesis is that there will be positive outcomes for patients of physicians in both interventions but better outcomes for those patients whose doctors participate in the cultural competence training (PACE PLUS). That is: a) PACE PLUS compared to PACE will produce reductions in health care use, improved symptoms, greater parent satisfaction with care, enhanced quality of life, higher levels of physician confidence in working cross culturally, increased use of NAEPP guidelines by physicians. b) PACE Compared to a control group will produce better outcomes on these six dimensions. Data will be collected through survey of physicians and telephone interviews with the child's parent/caretaker. Medical records of physicians will be reviewed to verify parent's reports of health care use.

描述（由申请人提供）：每年都在医生的文化能力培训上花费大量的努力和资源。这种培训是美国几乎每所医学院课程的一部分，也是全国继续医学教育的重点。但是，尚无严格的研究评估医生的文化能力培训是否为患者带来更好的健康结果。此应用程序响应PA-08-083。我们建议进行一项随机临床试验，涉及亚特兰大，佐治亚州和纽约，纽约以及1192名非裔美国人和波多黎各哮喘患者的1192名临床医生。两组患者都被证明是哮喘患病率最高的患病率及其疾病问题的患者之一。将研究两种干预措施。首先是一项经过验证的计划，即医师哮喘护理教育（PACE），用于增强医师的临床治疗，沟通和咨询技能，这些技巧可为哮喘儿童的普通儿童带来积极的成果。第二版是该计划的版本，旨在增强临床医生的文化能力，特别是在与目标患者人群（PACE PLUS）合作时。拟议的研究将回答两个问题：1）文化能力培训（PACE PLUS）对少数民族患者，特别是非裔美国人和波多黎各儿童及其父母的结果是否比一般的通信培训计划（PACE）更好？ 2）与对照组相比，是PACE计划，已经证明对一般患者人群有效，当与少数族裔患者（特别是非裔美国人和波多黎各儿童及其父母）一起使用时有效。研究假设是，在两种干预措施中，医生的患者都会取得积极的结果，但是对于那些医生参加文化能力培训的患者（PACE PLUS）的患者将取得更好的结果。也就是说：a）与速度相比，PACE PLUS将减少医疗保健的使用，改善症状，对护理的更高满意度，增强的生活质量，医师对跨文化工作的信心更高，医生增加使用NAEPP指南。 b）与对照组相比，速度将在这六个维度上产生更好的结果。数据将通过对医生的调查以及对孩子的父母/看守人进行的电话采访来收集数据。将审查医师的病历，以验证父母的医疗保健使用报告。