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Reducing Healthcare Disparities with Shared Decision Making

通过共同决策减少医疗保健差异

基本信息

批准号：
9042942
负责人：
MARSHALL H CHIN
金额：
$ 49.76万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-04-01 至 2018-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9042942
关键词：
Reducing Healthcare Disparities Shared Decision

项目摘要

DESCRIPTION (provided by applicant): Shared decision making (SDM) between patients and providers has been associated with improved diabetes control, lowered blood pressure, and other positive health outcomes. However, most SDM studies have been conducted in majority populations in well-resourced clinical settings, and thus a major void exists about what SDM content and processes are most likely to improve outcomes for minority populations in under-resourced settings. Thus, this proposal's specific aims are: 1. To systematically review key issues in shared decision making around paradigmatic conditions or situations for racial and ethnic minority populations, children, older persons, surrogate decision makers, men who have sex with men, and transgender individuals. a. To explore what is known about these groups regarding the SDM domains of information sharing, deliberation, and decision making. b. To identify what tools have improved SDM in minority populations. c. To explore what is known about contextual factors affecting SDM in these populations 2. To obtain the input and feedback from diverse stakeholders (including organizations, community groups, health care delivery systems, clinicians, and patients) representing minority populations and under- resourced settings around desired shared decision making interventions. a. To determine desired content, presentation of information, and process for SDM. b. To tailor to traditional media, social media, and health information technology (HIT). c. To determine priorities for development and implementation of SDM products. d. To determine contextual factors affecting SDM such as design of clinic, incentives, and implementation issues 3. To develop tools to help stakeholders implement and evaluate SDM interventions in minority populations in under-resourced settings. The study team will systematically review the literature and perform interviews, focus groups, key stakeholder meetings, and community forums across diverse stakeholder groups to accomplish these goals. The project's tools will help create a culture conducive to effective SDM in minority populations, facilitate development and revision of existing SDM tools for minority populations, and provide templates to evaluate SDM interventions in under-resourced settings.

描述（由申请人提供）：患者和提供者之间的共同决策（SDM）与改善糖尿病控制、降低血压和其他积极的健康结果相关。然而，大多数SDM研究都是在资源充足的临床环境中的大多数人群中进行的，因此关于SDM的内容和过程最有可能改善资源不足环境中少数人群的结果存在重大空白。因此，本提案的具体目标是：1.系统地审查围绕种族和少数民族人口、儿童、老年人、代理决策者、男男性行为者和变性人的典型条件或情况共同决策的关键问题。 a.探索这些群体在信息共享、审议和决策领域的知识。 B.确定哪些工具改善了少数群体的可持续发展管理。 C.为了探索什么是已知的背景因素影响SDM在这些人群中2。从代表少数群体和资源不足环境的不同利益相关者（包括组织、社区团体、医疗保健提供系统、临床医生和患者）获得关于期望的共同决策干预措施的投入和反馈。 a.确定SDM所需的内容、信息表示和流程。 B.为传统媒体，社交媒体，健康信息技术（HIT）。 C.确定“可持续发展机制”产品开发和实施的优先次序。 D.确定影响SDM的背景因素，如诊所的设计，激励措施和实施问题3。开发工具，帮助利益攸关方在资源不足的情况下对少数群体实施和评估可持续发展机制干预措施。研究团队将系统地审查文献，并在不同的利益相关者群体中进行访谈，焦点小组，关键利益相关者会议和社区论坛，以实现这些目标。该项目的工具将有助于在少数群体中创造一种有利于有效的可持续发展机制的文化，促进为少数群体开发和修订现有的可持续发展机制工具，并提供模板，以评估在资源不足的情况下可持续发展机制的干预措施。