In This Issue: Advancements in VA Mental Healthcare
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Ineffective communication between patients of racial and ethnic minority backgrounds and their providers is a significant contributor to healthcare disparities, including mental healthcare disparities. Minority patients across care settings consistently rate the quality of communication with their clinicians as poorer than White patients, and studies describe these interactions as marked by conflicts, perceptions of discrimination, clinicians' dominance, and exclusion of patients in treatment decisions. This is problematic because suboptimal patient-provider communication has been linked to poorer health outcomes, lower patient satisfaction, and reduced patient-engagement. Despite efforts to improve patient-provider interactions, disparities in patient-provider communication persist among minority patients.
Moreover, lower levels of participation in shared decision-making (SDM) by minority patients is recognized as a significant contributor to racial and ethnic differences in patient-provider communication. Current efforts to improve patients' participation in SDM are limited by lack of understanding and integration of patients' social contexts in their treatment, and inadequate attention to precursors to SDM, such as patient engagement. While it is well established that effective communication is critical for patient-centered care and the reduction of healthcare disparities, few interventions have been developed and/or implemented to improve patient-provider communication among minority groups.
Therefore, the objectives of this ongoing five-year HSR&D study (March 2018 – February 2023) are to develop and test a peer-led patient navigation intervention – in a randomized controlled trial – to improve minority Veterans' participation in shared decision-making and treatment engagement in VA mental healthcare. Investigators will also identify provider- and systems-level barriers and facilitators to intervention implementation, thereby identifying practices that need to be modified or integrated into the intervention to ensure its effective implementation and sustainability.
Findings from this study will contribute to VA's efforts to improve patient-provider communication and reduce VA mental healthcare disparities. Moreover, this study could affect the delivery of mental healthcare to minority Veterans.
Principal Investigator: Johanne Eliacin, PhD, HSPP, is an HSR&D Career Development Awardee and a core investigator with HSR&D’s Center for Health Information and Communication (CHIC), Indianapolis, IN.
View study abstract