Comparative Effectiveness of Standard versus Patient‐Centered Collaborative Care Interventions for Depression among African Americans in Primary Care Settings: The BRIDGE Study

Cooper, Lisa A.; Dinoso, Bri K. Ghods; Ford, Daniel E.; Roter, Debra; Primm, Annelle B.; Larson, Susan; Gill, James M.; Noronha, Gary; Shaya, Elias K.; Wang, Nae Yuh

doi:10.1111/j.1475-6773.2012.01435.x

Cited by 54 publications

(63 citation statements)

References 56 publications

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“…Specifically, the numerator consists of certain parent codes (all questions, psychosocial and lifestyle information and emotional talk) plus medical team codes (psychosocial and lifestyle questions, psychosocial and lifestyle information and counselling, emotionally responsive statements, partnering and activation statements). The denominator includes certain parent codes (medical information and questions) plus medical team codes (medical and therapeutic regimen information and counselling; medical questions; instructions and orientation (34, 35). …”

Section: Methodsmentioning

confidence: 99%

Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences*

October

Hinds

Wang

et al. 2016

Pediatric Critical Care Medicine

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Objective To evaluate the association between physician’s patient-centered communication patterns and parental satisfaction during decision-making family conferences in the pediatric intensive care unit. Design Single-site, cross-sectional study. Setting Forty-four bed pediatric intensive care unit in a free-standing children’s hospital. Participants Sixty-seven English-speaking parents of 39 children who participated in an audio-recorded family conference with 11 critical care attending physicians. Measurements and Main Results Thirty-nine family conferences were audio-recorded. Sixty-seven of 77 (92%) eligible parents enrolled. The conference recordings were coded using the Roter Interaction Analysis System (RIAS) and a RIAS-based patient-centeredness score, which quantitatively evaluates the conversations for physician verbal dominance and discussion of psychosocial elements such as a family’s goals and preferences. Higher patient-centeredness scores reflect higher proportionate dialogue focused on psychosocial, lifestyle and socio-emotional topics relative to medically-focused talk. Parents completed satisfaction surveys within 24-hours of the conference. Conferences averaged 45 minutes in length (SD 19 min), during which the medical team contributed 73% of the dialogue compared to parental contribution of 27%. Physicians dominated the medical team, contributing 89% of the team contribution to the dialogue. The majority of physician speech was medically-focused (79%). A patient-centeredness score ≥0.75 predicted parental satisfaction (β=12.05, p<0.0001), controlling for length of conference, child severity of illness, parent race and socioeconomic status. Parent satisfaction was negatively influenced by severity of illness of the patient (β= −4.34, p=0.0003), controlling for previously mentioned factors in the model. Conclusion Parent-physician interactions with more patient-centered elements, such as increased proportions of empathetic statements, question-asking and emotional talk, positively influence parent satisfaction despite the child’s severity of illness.

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Section: Methodsmentioning

confidence: 99%

Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences*

October

Hinds

Wang

et al. 2016

Pediatric Critical Care Medicine

Self Cite

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“…A recent trial enhancing collaborations between community agencies and the health care system improved depression outcomes in predominantly minority (46% African-American, 41% Latino) safety-net clients 44. The BRIDGE trial showed that standard CC and patient-centered culturally adapted CC had similar benefits on depression outcomes in African-American patients, although patient satisfaction was greater in those receiving the culturally adapted approach 46. Another trial found that six telepsychiatry sessions provided by a bilingual psychiatrist to low-income Hispanic primary care patients was superior to usual care in improving depression outcomes 47.…”

Section: Added Benefits For Minority Underserved and Other Vulnerabmentioning

confidence: 99%

Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care

2017

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Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety. Six key components of CC include a population-based approach, measurement-based care, treatment to target strategy, care management, supervision by a mental health professional (MHP), and brief psychological therapies. Multiple trials have also shown that CC for depression is equally or more cost-effective than many of the current treatments for medical disorders. Factors that may facilitate the implementation of CC include a more favorable alignment of medical and mental health services in accountable care organizations and patient-centered medical homes; greater use of telecare as well as automated outcome monitoring; identification of patients who might benefit most from CC; and systematic training of both PCPs and MHPs in integrated team-based care.

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“…Balint first described PCC as “understanding the patient as a unique human being.” During the 20th century, PCC became a focus of healthcare systems with its promise to increase patient satisfaction and improve outcomes . A growing body of evidence has linked PCC practices with improvements in a variety of health conditions, increased adherence, decreased healthcare utilization, better ratings of care and improved quality of care . By 2001, The Institute of Medicine identified PCC as a key aspect of high‐quality care .…”

Section: Introductionmentioning

confidence: 99%

Patient‐centred care is a way of doing things: How healthcare employees conceptualize patient‐centred care

Fix

Lukas

Bolton

et al. 2017

Health Expectations

160

119

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BackgroundPatient‐centred care is now ubiquitous in health services research, and healthcare systems are moving ahead with patient‐centred care implementation. Yet, little is known about how healthcare employees, charged with implementing patient‐centred care, conceptualize what they are implementing.ObjectiveTo examine how hospital employees conceptualize patient‐centred care.Research DesignWe conducted qualitative interviews about patient‐centred care during site four visits, from January to April 2013.SubjectsWe interviewed 107 employees, including leadership, middle managers, front line providers and staff at four US Veteran Health Administration (VHA) medical centres leading VHA's patient‐centred care transformation.MeasuresData were analysed using grounded thematic analysis. Findings were then mapped to established patient‐centred care constructs identified in the literature: taking a biopsychosocial perspective; viewing the patient‐as‐person; sharing power and responsibility; establishing a therapeutic alliance; and viewing the doctor‐as‐person.ResultsWe identified three distinct conceptualizations: (i) those that were well aligned with established patient‐centred care constructs surrounding the clinical encounter; (ii) others that extended conceptualizations of patient‐centred care into the organizational culture, encompassing the entire patient‐experience; and (iii) still others that were poorly aligned with patient‐centred care constructs, reflecting more traditional patient care practices.ConclusionsPatient‐centred care ideals have permeated into healthcare systems. Additionally, patient‐centred care has been expanded to encompass a cultural shift in care delivery, beginning with patients' experiences entering a facility. However, some healthcare employees, namely leadership, see patient‐centred care so broadly, it encompasses on‐going hospital initiatives, while others consider patient‐centred care as inherent to specific positions. These latter conceptualizations risk undermining patient‐centred care implementation by limiting transformational initiatives to specific providers or simply repackaging existing programmes.

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Comparative Effectiveness of Standard versus Patient‐Centered Collaborative Care Interventions for Depression among African Americans in Primary Care Settings: The BRIDGE Study

Cited by 54 publications

References 56 publications

Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences*

Parent Satisfaction With Communication Is Associated With Physician’s Patient-Centered Communication Patterns During Family Conferences*

Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care

Patient‐centred care is a way of doing things: How healthcare employees conceptualize patient‐centred care

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