Division of Clinical and Health Services Research

Research to understand how patient-clinician- health care system interactions affect clinical outcomes and health and health care disparities. Objectives are to:

1. Understand patient-clinician, clinician-clinician, clinician-health care system and/or patient-health care system engagement, partnership, trust, communication, and shared decision-making.
2. Understand patient-clinician communication and/or the patient-clinician relationship.
3. Develop, test and evaluate interventions that enhance patient-clinician-health care system interactions and their impact on health/clinical outcomes and the reduction of health and health care disparities.

Clinician and/or Health Care System Bias and Cultural Competence

Research focused on:

1. Assessing and understanding conscious and unconscious biases and cultural competency of health care providers and other actors within the health care system regarding patients from populations that experience health and health care disparities.
2. Assessing and understanding patients’ conscious and unconscious biases regarding health care providers.
3. Interventions to reduce those biases and improve cultural competence.

Studies may also assess the impact of those interventions on the quality of care, patients’ health/clinical outcomes, and reduction of health and health care disparities.

Program Contact: Dr. Sundania Wonnum

Patient-Clinician/Health Care System Communication

Research to:

1. Understand the nature and patterns of communication between patients and points of contact (clinical and non-clinical) at different levels within the health care system.
2. Develop interventions to facilitate effective bidirectional communication, build trust, and mutual respect between patient and clinician, and shared decision-making between health care systems and patients and their families.
3. Evaluate the effect of interventions on quality of care and health/clinical outcomes, and on reducing health and health care disparities.

Research examples include but are not limited to studies that:

• Evaluate effective integration of patient communication preferences in clinical encounters.
• Assess how patients’ preferences for shared decision-making impacts communication with clinicians.
• Delineate pathways of communication for patients with disabilities that interfere with typical spoken communication.

Program Contact: Dr. Yewande Oladeinde

Patient Engagement and/or Partnership in Care

Research within clinical settings or in the community offered in conjunction with clinical care to:

• Understand factors in clinical care that facilitate or challenge patient agency, engagement, and/or partnership across the continuum of care.
• Develop interventions to enhance agency, engagement, and/or partnership and evaluate the effect of these interventions on clinical outcomes and/or health and health care disparities.

Research examples include but are not limited studies to:

• Develop, test, and evaluate patient self-management interventions.
• Assess the impact of different health information technologies on health education interventions.
• Determine which patients are most likely to benefit from self-management or supported interventions.

Program Contact: Dr. Yewande Oladeinde

Clinician-Clinician/Healthcare Team Interactions and Wellbeing

Research to:

• Understand care team structure and processes that impact care decisions, clinical care processes, equitable access to quality care, and health and health care disparities.
• Develop and evaluate interventions to improve team-based care delivery and interprofessional competencies.
• Develop and evaluate interventions or address challenges to and breakdowns in care coordination, communication, and collaboration.
• Understand and address the needs of the health care workforce, including workforce supply, distribution, competencies, and diversity, as well as clinical burden, burnout, and resilience.

Research examples include but are not limited to studies that:

• Assess care team structure and processes that promote comprehensive care coordination, effective care transitions, and continuity of care.
• Develop and evaluate interventions to address clinician burnout.
• Assess multi-level interventions to address clinician fatigue.

Program Contact: Dr. Carolina Solís Sanabria

Research to identify patterns of healthcare utilization, quality, and outcomes, as well as to identify social, environmental, and other determinants of health care utilization patterns and health/clinical outcomes and their contributions to health and health care disparities across the life course.

This type of research may include longitudinal studies, natural experiments (resulting from changes in public or health policies, for example), and predictive or simulation modelling. The use of advanced analytics may include data mining, machine learning, and artificial intelligence. Research may include the linkage of existing and emerging data sources that capture and harmonize data from multiple contextual levels, including the patient, clinician, healthcare team, health system, neighborhood, and policy levels, and the establishment of data repositories and data standardization using common data elements such as the PhenX toolkit.

Program Contact: Dr. Rada Dagher

Research to understand how health care system factors influence health/clinical outcomes.

Health Care System Organization and Coordination

Research that examines how the structure and organization of health care delivery affects health service access, utilization, and clinical outcomes.

Research examples include but are not limited to studies that:

• Evaluate or design interventions involving different units or levels of health care coordination within a single health care system or across multiple health care systems.
• Assess the components of existing or newly designed health care models.
• Evaluate the effectiveness of various strategies to increase the supply of and access to clinicians in medically underserved areas.
• Develop and test coordination and collaboration tools and/or modalities using health information technology or telemedicine.

Program Contact: Dr. Yewande Oladeinde

Health Care Policies

Research to:

• Examine and evaluate the impact of changes in local, state, and/or federal health care policies on health services access, utilization, quality of care, and clinical outcomes.
• Design health policy interventions that make the health care delivery system more affordable, equitable, and higher quality.

Research examples include but are not limited to studies that:

• Evaluate the impact of a specific health care or public policy on access to care.
• Develop and test policy interventions to improve adoption and implementation of evidence-based clinical recommendations.

Program Contact: Dr. Rada Dagher

Interventions to Improve Quality of Care

Research to develop and/or evaluate interventions (health care system-wide or multi-level with system-level components) to reduce system bias, increase health equity, improve access to care, quality of care, and clinical outcomes.

Research examples include but are not limited to studies that:

• Optimally define and assess the integration of social determinants of health in electronic health records or social care into clinical practice.
• Assess the impact of telemedicine on continuity of care, treatment adherence, and/or clinical outcomes.
• Assess the effects of in-home medical services (including pharmacy) on clinical outcomes.

Program Contact: Dr. Dolly Penn White

Research to understand health care utilization and outcomes in association with services and treatment provided in community-based settings (outside of traditional health care systems) for populations that experience health and/or health care disparities. Studies that explore community health systems and/or academic partnerships. Studies that seek to understand the medical neighborhood and interactions between health care systems and community-based settings.

Health Care Delivery in Behavioral Health Settings

Research to understand and/or improve formal care for populations that experience health and/or health care disparities in community based mental health, drug treatment, and related settings, including clinics, private practice settings, residential treatment facilities, and detoxification centers.

Program Contact: Dr. Rada Dagher

Health Care Delivery in Long-Term, Palliative, or End-of-Life Care Settings

Research to understand or improve formal health care provided to populations that experience health and/or health care disparities (including underserved rural populations) in nursing homes, rehabilitation centers, assisted-living facilities, hospice settings, long-term care facilities, ambulatory or home-based palliative care, and in home-based long-term health care.

Program Contact: Dr. Lynne Padgett

Health Care Delivery in Non-Healthcare Settings

Research to understand or improve formal health care provided to populations that experience health and/or health care disparities in school-based health centers, the workplace, and criminal justice settings. This does not include health promotion activities that may be delivered by non-medical personnel in those or other settings (for example, health fairs).

Program Contact: Dr. Sundania Wonnum