(provided by candidate): Research has consistently shown that African-Americans with diabetes mellitus have worse health outcomes than whites. The literature also demonstrates that enhanced shared decision-making (SDM) and patient-centered care can improve diabetic outcomes. What we do not yet understand is why African-Americans have less shared-decision making than whites, how we can enhance shared decision-making in this population, and whether increasing SDM among African-Americans can lead to improvements in health outcomes and reductions in diabetic health disparities. I am an internist with an interest in exploring the impact of race/culture on the patient/provider relationship and reducing diabetic health disparities. Within the next five years, I want to be able to reduce African-American diabetic disparities by developing interventions grounded in research that enhance shared decision-making and diabetes self-management. In order to achieve this long-term goal, I plan to obtain additional research training through formal coursework, intensive mentoring, research conferences, and the completion of a series of research projects that include survey research methods, qualitative research, and behavioral intervention evaluation. My research proposal has the following specific aims: 1) To compare racial differences in patient preference for participatory decision-making and in the concordance between such preferences and physician behavior, 2) To explore how race and culture impact SDM between patients and health care providers, and 3) To develop and pilot test a culturally appropriate educational intervention for African-American patients with diabetes that enhances shared decision-making. By investigating and improving SDM among African-Americans with diabetes, we can make important advances in improving health outcomes and reducing health disparities within this population. This proposed research, along with additional training, will help me reach my goal of being an independent clinician investigator. Towards this end, I am able to draw upon the enormous strengths of two institutions with complementary resources and skills. Rush University Medical Center/John Stroger Hospital has an historic mission of providing care to primarily uninsured low-income ethnically diverse patients within a large public health system, while the University of Chicago has exceptional researchers and infrastructure with which to investigate issues of the medically underserved in a rigorous way.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK075006-05
Application #
7900880
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Hyde, James F
Project Start
2006-09-10
Project End
2011-07-31
Budget Start
2010-08-01
Budget End
2011-07-31
Support Year
5
Fiscal Year
2010
Total Cost
$124,524
Indirect Cost
Name
University of Chicago
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
Goddu, Anna P; Raffel, Katie E; Peek, Monica E (2015) A story of change: The influence of narrative on African-Americans with diabetes. Patient Educ Couns 98:1017-24
Peek, Monica E; Ferguson, Molly; Bergeron, Nyahne et al. (2014) Integrated community-healthcare diabetes interventions to reduce disparities. Curr Diab Rep 14:467
Peek, Monica E; Drum, Melinda; Cooper, Lisa A (2014) The Association of Patient Chronic Disease Burden and Self-Management Requirements With Shared Decision Making in Primary Care Visits. Health Serv Res Manag Epidemiol 1:
Chien, Alyna T; Chin, Marshall H; Alexander, G Caleb et al. (2014) Physician financial incentives and care for the underserved in the United States. Am J Manag Care 20:121-9
Nundy, Shantanu; Mishra, Anjuli; Hogan, Patrick et al. (2014) How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study. Diabetes Educ 40:806-19
Nundy, Shantanu; Dick, Jonathan J; Chou, Chia-Hung et al. (2014) Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants. Health Aff (Millwood) 33:265-72
Nundy, Shantanu; Dick, Jonathan J; Solomon, Marla C et al. (2013) Developing a behavioral model for mobile phone-based diabetes interventions. Patient Educ Couns 90:125-32
Peek, Monica E; Gorawara-Bhat, Rita; Quinn, Michael T et al. (2013) Patient trust in physicians and shared decision-making among African-Americans with diabetes. Health Commun 28:616-23
Peek, Monica E; Harmon, Sheila A; Scott, Shelley J et al. (2012) Culturally tailoring patient education and communication skills training to empower African-Americans with diabetes. Transl Behav Med 2:296-308
Peek, Monica E; Wilson, Shannon C; Bussey-Jones, Jada et al. (2012) A study of national physician organizations' efforts to reduce racial and ethnic health disparities in the United States. Acad Med 87:694-700

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