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CBSSM Researchers: 

Funded by Blue Cross Blue Shield of Michigan Foundation

PI: Thomas Valley

Research Topics: 
CBSSM Researchers: 

Patient-physician racial discordance is strongly associated with patient dissatisfaction and mistrust in physicians, which is further associated with poor treatment adherence and suboptimal healthcare utilization. This poses serious public health challenges because approximately 80-90% of Black patients see physicians from different racial groups. Patient dissatisfaction and mistrust have been recently found to be particularly magnified when physicians hold high levels of automatic, implicit bias toward Black Americans, suggesting that physicians’ implicit racial bias impacts physician communication behaviors during medical interactions and ultimately Black patient outcomes. The overall goal of this research is to identify physicians’ communication behaviors during medical interactions that are associated with physicians’ implicit racial bias and Black patients’ immediate (satisfaction, trust) as well as clinically important longer-term outcomes (adherence, healthcare utilization). To achieve this goal, we target medical interactions involving Black patients with Type 2 diabetes mellitus (T2DM) because nonadherence in Black patients with T2DM is particularly prevalent. Additionally, the patient-physician communication quality has been found to predict patient adherence to T2DM treatment regimens. We will use a mixed-methods design that integrates the strengths of inductive reasoning to explore which physicians’ communication behaviors during medical interactions matter from Black patients’ perspectives and deductive reasoning to identify theoretically and clinically important behaviors.

CBSSM Researchers: 

A Knowledge-Delivery Mechanism, Empowering Clinicians to Improve Patient Experience of CancerDLHS received funding from Genentech’s Corporate Giving Support program in 2016 for “A Novel Knowledge-Delivery Mechanism Empowering Clinicians to Improve Patient Experience of  Cancer Care.” The project focuses on making actionable knowledge about the patient experience of chemotherapy computable and on using that knowledge to add customizable decision-support to a prototype Patient data dashboard so that clinicians can provide great support to patients who are at home.

Funded by Michigan Department of Health and Human Services (Subcontract)

Investigators from University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), in partnership with the Detroit Health Department, the Southfield-Joy Community Development Corporation and five health plans insuring Detroit-based Medicaid and Healthy Michigan enrollees have collaboratively developed an innovative new model for a Community Health Worker-led (CHW) demonstration project in Detroit’s Cody Rouge neighborhood. The demonstration project will evaluate a potentially financially sustainable model targeting neighborhoods with high numbers of high- and under-health care utilizing Medicaid enrollees. The health plans will each deploy one of their CHWs to the project for a 12-month period. After undergoing joint training through the Michigan Community Health Worker Alliance (MICHWA) program and using assessment tools that cover shared domains, the CHWs will proactively reach out to identified beneficiaries to conduct an initial health and social needs assessment, develop an individualized ‘action plan’ with each beneficiary, work with neighborhood-based organizations to address each enrollee’s unique needs, and provide follow-up support as needed. CHWs will work closely with local organizations both to meet program participants’ needs and to strengthen community capacity to bridge gaps between healthcare services and community-level social determinants of health. The Detroit Health Department will provide office space for the CHWs to meet weekly in a neighborhood facility and provide ongoing booster support and mentorship. UM investigators will evaluate the program in a parallel, two-armed, randomized controlled pragmatic trial. We will evaluate effect on health care utilization among high-utilizing participants and zero-utilizing participants (ED visits, hospitalizations, primary care use) and health care costs at 6- and 12-months and compared to eligible individuals not yet enrolled in the project, on key patient-centered outcomes, and project costs, return on investment, and barriers and facilitators to adoption, implementation, maintenance, and potential spread.

CBSSM Researchers: 

The major goals of this project are to identify the degree to which social disparities exist in physicians' communication about important clinical issues with patients with serious and life-limiting illnesses. This project also studies patient communication behaviors that exacerbate or attenuate those disparities. Results from this research will inform interventions for physicians and patients to promote better communication and thereby reduce or eliminate social disparities in care.

CBSSM Researchers: 

Patients with type 2 diabetes are increasingly living with multiple concurrent conditions and complicated medical regimens. For these patients, diabetes management decisions and treatment goals must be addressed within the larger context of other competing health concerns.

Research Topics: 

Obesity is increasingly considered among the most important public health problems of our times. Bariatric surgery is arguably the only treatment that has proven effective in producing long-term weight loss for patients with morbid obesity. Bariatric surgery also results in resolution of obesity related comorbid conditions, improvements in quality of life, and increased survival.

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