This is a proposal for a K24 Midcareer Investigator Award in Patient-oriented Research for Mary Catherine Beach, MD, MPH of the Johns Hopkins University School of Medicine. Dr. Beach is an Associate Professor of Medicine in the Division of General Internal Medicine and Core Faculty in the Welch Center for Prevention, Epidemiology and Clinical Research. Dr. Beach has spent the majority of her career and scholarship over the past 10 years focusing on patient-oriented research in populations with a high prevalence of substance abuse (or perception of substance abuse) that negatively impacts quality of care and health outcomes. Despite a well- established evidence base that high-quality respectful patient-clinician communication and relationships are critically important to patient outcomes, there are wide gaps in our current understanding of patient-clinician communication in the treatment of HIV/AIDS and drug abuse. One recent systematic review determined that therapeutic alliance between patient and counselor was most important in predicting drug treatment outcomes but little is known about how a therapeutic alliance is built in medical settings between physicians and patients with active drug use. This K24 award will protect time for the applicant to mentor junior investigators and conduct significant original research aimed at improving communication and relationships between clinicians and patients with substance abuse.
The aims of the original research are: (1) to explore the quality of provider counseling about substance abuse treatment within routine ambulatory primary HIV care encounters, identify reasons for missed opportunities for counseling, identify correlates of higher quality counseling, and prioritize recommendations for provider training, (2) To discover, using the sociolinguistic technique of conversation analysis, which patterns of asking about and addressing anti-retroviral adherence are most reliable and effective in clinical encounters among HIV-infected patients with substance abuse, and (3) to analyze the vocal tone on a sample of audio-recorded encounters and examine whether higher levels of respectfulness and warmth as rated by independent observers predict continued patient engagement in care among HIV-infected patients with substance abuse.
These aims will be addressed in the context of providing mentorship to new and existing junior faculty, post-doctoral fellows and students. The K24 will allow Dr. Beach to more effectively pursue her long-term career goals to enhance respect, to improve communication, and to better the patients' experiences, all for the purpose of reducing suffering and improving health and well-being of these underserved and stigmatized populations.

Public Health Relevance

This is a proposal for a Midcareer Investigator Award in Patient-Oriented Research (K24) for Mary Catherine Beach, MD, MPH. This award will support Dr. Beach's research program in patient-provider communication in HIV care; the overarching aim of this research is to understand and improve the quality of care and clinical outcomes for populations with a high prevalence of substance abuse that negatively impacts quality of care and health outcomes. These aims are addressed in the context of providing mentorship to new and existing junior faculty, post-doctoral fellows and students.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24DA037804-05
Application #
9634057
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Flournoy Floyd, Minnjuan Wyncephel
Project Start
2015-02-01
Project End
2021-01-31
Budget Start
2019-02-01
Budget End
2021-01-31
Support Year
5
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Beach, Mary Catherine; Topazian, Rachel; Chan, Kitty S et al. (2018) Climate of Respect Evaluation in ICUs: Development of an Instrument (ICU-CORE). Crit Care Med 46:e502-e507
Callon, Wynne; Beach, Mary Catherine; Links, Anne R et al. (2018) An expanded framework to define and measure shared decision-making in dialogue: A 'top-down' and 'bottom-up' approach. Patient Educ Couns 101:1368-1377
Beach, Mary Catherine; Laws, M Barton; Rose, Gary et al. (2018) Effects of Minimal Versus Intensive Intervention to Enhance Motivational Interviewing in HIV Care. AIDS Behav 22:276-286
Callon, Wynne; Saha, Somnath; Wilson, Ira B et al. (2017) How does decision complexity affect shared decision making? An analysis of patient-provider antiretroviral initiation dialogue. Patient Educ Couns 100:919-926
Callon, Wynne; Beach, Mary Catherine; Saha, Somnath et al. (2016) Assessing Problematic Substance Use in HIV Care: Which Questions Elicit Accurate Patient Disclosures? J Gen Intern Med 31:1141-7
Flickinger, Tabor E; Saha, Somnath; Roter, Debra et al. (2016) Respecting patients is associated with more patient-centered communication behaviors in clinical encounters. Patient Educ Couns 99:250-5
Bediako, Shawn M; Lanzkron, Sophie; Diener-West, Marie et al. (2016) The Measure of Sickle Cell Stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study. J Health Psychol 21:808-20
Callon, Wynne; Saha, Somnath; Korthuis, P Todd et al. (2016) Which Clinician Questions Elicit Accurate Disclosure of Antiretroviral Non-adherence When Talking to Patients? AIDS Behav 20:1108-15
Flickinger, Tabor E; Saha, Somnath; Roter, Debra et al. (2016) Clinician empathy is associated with differences in patient-clinician communication behaviors and higher medication self-efficacy in HIV care. Patient Educ Couns 99:220-6
Hughes, Helen Kinsman; Korthuis, Philip Todd; Saha, Somnath et al. (2015) A mixed methods study of patient-provider communication about opioid analgesics. Patient Educ Couns 98:453-61

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