The impacts of adverse provider conditions on provider bias and health disparities

Ended Project Grant Awarded Last action

Award ID
R01MD019051
Recipient
Awarding agency
Obligated
$5,264,381

Award facts

Completion date
Place of performance
Arkansas, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Healthcare disparities that adversely affect patients from racial and ethnic minoritized groups are often attributed to provider level factors such as implicit bias. However, efforts to reduce disparities have been hindered by an incomplete knowledge of factors that leave providers more vulnerable to bias and their underlying mechanisms. This proposal will address this critical knowledge GAP by identifying situations that increase bias among healthcare providers that can be intervened on at the provider and system level. The proposed research leverages theory from psychology and psychoneuroimmunology to document the impact of three adverse provider conditions (APCS) that could increase provider bias: (1) workplace demands (e.g., heightened levels of stress or burnout), (2) concerns about one's own health, and (3) increased inflammation occurring during illness. We hypothesize that when providers experience higher (versus lower) workplace demands, are more (versus less) concerned about their own health, and experience higher (versus lower) acute inflammation, they will demonstrate more bias against patients from racial and ethnic minoritized groups. We will test our hypothesis in the context of abdominal pain treatment in emergency departments. Participants will be attending physicians, nurse practitioners, physician's assistants, and residents in emergency medicine and internal medicine hospitalists who treat abdominal pain for patients who are admitted. We will address three specific aims to document effects of APCS on quality of care disparities. To address aim 1, we will use a correlational design to determine the relationship between APCS and standardized assessments of bias (implicit and explicit bias, perception of others' pain, and social avoidance). To address aim 2, we will use a randomized controlled intervention design; we will use the influenza vaccine to simulate illness by experimentally increasing inflammation (indexed by pro-inflammatory cytokine levels). Increases in cytokines are hypothesized to be positively associated with standardized assessments of bias. To address aim 3, we will use a prospective, longitudinal design to tracks provider illness symptoms, stress, burnout, and local cases of infectious illness over the course of a year. These provider data will be correlated with patient data from abdominal pain cases treated by the provider on those days. This study has high ecological validity and findings will identify distinct contributions of APCS to lower quality of care, especially for patients from racial and minoritized groups. Overall, the proposed research will have widespread positive impact by outlining paths for novel interventions at multiple levels and domains of influence within the nimhd research framework, such as by engaging administrator and clinical management stakeholders in conversations about consequences of staffing policies for health disparities.

Transactions

Action Obligated Date
Amendment $0
Amendment The impacts of adverse provider conditions on medical decision-making and patient care. $1,871,394
Amendment $1,871,394
Amendment $0
Amendment The impacts of adverse provider conditions on medical decision-making and patient care. $0
Amendment $0
Amendment $720,610
Amendment $0
Amendment $0
Amendment $0
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Amendment $0
Original award $800,983
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Subawards

Subrecipient Amount Awarded
Loma Linda University In Year 1, Dr. Schulz will communicate with Dr. Makhanova and participating sites in this multi-site study to develop the research protocol for the experimental… $90,358
Carilion Medical Center In Year 1, Dr. Wilson will oversee recruitment of Carilion healthcare providers to the experimental trial described in Aims 1 and 2. Dr. Wilson will oversee all… $71,453
The University Of Texas At San Antonio UTSA Statement of Work PI Joseph Houpt will be responsible for assisting with overall study design and implementation in Year 1 of the project and will meet… $132,639
Florida State University FSU Statement of Work PI Eric Shattuck will be responsible for assisting with overall study design and implementation in Year 1 of the project and will meet… $114,409
University Of New Mexico In Year 1, Dr. Alcock will develop recruitment advertising materials and a recruitment timetable, strategy and enrollment milestones. He will develop and refine… $87,697

Quick answers

Who received award R01MD019051?

R01MD019051 was awarded to University Of Arkansas by National Institute for Minority Health and Health Disparities (National Institutes of Health) on September 17, 2024.

How much is award R01MD019051 worth?

$5,264,381 has been obligated on R01MD019051.

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