Variations in physician practice and disparities in healthcare raise questions about the patient-centeredness of decisions that determine what care is provided to whom and whether this contributes to prevailing health and healthcare disparities. Variation in physician practice and persistent health disparities in chronic disease may, in part, be explained by a lack of patient involvement in treatment decisions, particularly among racial and ethnic minority patients. Yet the shared decision making experiences of vulnerable populations are poorly understood. The overall goal of this career development award proposal is to acquire knowledge, skill and expertise in shared decision making processes, the comparative effectiveness of shared decision making tools versus usual care, and the impact of decision support tools on health disparities in cardiovascular disease among culturally diverse, medically underserved populations. A strategy comprised of coursework and mentored research experience will provide expertise in shared decision making behaviors of vulnerable populations. A secondary data analysis will offer insight into the relationship between shared decision making and disparities in decision quality and outcomes. These findings will inform a qualitative interview guide for a series of semi-structured interviews designed to characterize socially determined predictors of shared decision making behavior and decision implementation difficulties. The research from these two studies will be translated into the development of a novel, health information technology driven, interactive shared decision making intervention with the goal of reducing healthcare access and communication barriers that limit full participation in the shared decision making processes for culturally diverse vulnerable populations.

Public Health Relevance

This mentored career development award proposal aims to provide the necessary skills and training for an independent investigator to conduct research on novel interactive technology-driven decision support tools for patients with cardiovascular disease.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HS019771-03
Application #
8271234
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
Project Start
2010-09-30
Project End
2015-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
3
Fiscal Year
2012
Total Cost
Indirect Cost
Name
Boston Medical Center
Department
Type
DUNS #
005492160
City
Boston
State
MA
Country
United States
Zip Code
02118
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Mitchell, Suzanne E; Mako, Morgan; Sadikova, Ekaterina et al. (2014) The comparative experiences of women in control: diabetes self-management education in a virtual world. J Diabetes Sci Technol 8:1185-92
Gardiner, Paula; Mitchell, Suzanne; Filippelli, Amanda C et al. (2013) Health literacy and complementary and alternative medicine use among underserved inpatients in a safety net hospital. J Health Commun 18 Suppl 1:290-7