NCCAM's 2005 Strategic Plan includes the exploration of organized health care delivery models which integrate complementary and alternative medicines (CAM) with conventional care. The 2007 National Health Interview Survey reports that approximately one in five adults use Herbs and non-vitamin Dietary Supplements (HDS). However, little is known about the number of inpatients in urban underserved hospitals who continue to use HDS while receiving treatment with allopathic medicines. Similarly, little is known about factors associated with potential HDS adverse events in hospital settings. Health information technology holds promise as an innovative and effective way to deliver HDS information to underserved patients and their physicians. This K07 application proposes essential first steps toward (1) developing a solid knowledge base about HDS use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based HDS information to underserved inpatients and their physicians, in particular through health information technology. The research objectives of this application are: (1) to contribute to the knowledge base about HDS use among minority inpatients;(2) to design culturally sensitive literacy-informed patient-centered information technology systems to teach about HDS;and (3) to develop a patient safety curriculum that will help clinicians document HDS use and communicate effectively with their patients about HDS. To achieve these objectives, this K07 application has three specific aims: (1) Investigate the association between HDS use, health literacy, medication use, and hospital utilization in a sample of 750 hospitalized patients;(2) Conduct a randomized clinical trial in sixty women who will receive a hospitalized discharge plan on cranberry delivered by a virtual patient advocate (a computerized, animated, empathic character), and a control group who receives the same information via a cranberry patient information sheet;and (3) Design, program, and evaluate a web-based HDS patient safety curriculum for clinicians, then utilize pre and post measures and chart reviews to assess its impact on clinician-patient HDS communication. Completion of this research will be supported by: (1) a core of highly skilled mentors and consultants;and (2) completion of a Graduate Certificate in Instructional Technology at the Boston University School of Education. The candidate's career goals are to become (1) an independent HDS research investigator and educator for underserved populations, and (2) a national leader in the use of health information technology for HDS patient and clinician education. To prepare herself to accomplish these career goals, as well as the research objectives outlined above, the candidate proposes (1) to undertake mentored training in patient safety, health care disparities, health literacy, and epidemiologic methods, and (2) to pursue course-working clinical trial design, statistical analysis, human subject protections, and online curriculum development. This award will effectively prepare the candidate to become a successful independently-funded HDS investigator, focused on the needs of underserved patients, and an expert in applying health information technology to the study and teaching of CAM.
Despite widespread herb use, little is known about inpatient use of herbs and non-vitamin dietary supplements in urban underserved hospitals. In this K07 Academic Career Development application, the candidate proposes essential first steps toward (1) developing a solid knowledge base about herb use in underserved hospital patients, and (2) designing and piloting innovative methods to effectively deliver evidenced-based herbal information to underserved inpatients and their physicians using health information technology.
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