PNWU has been awarded a National Institutes of Health (NIH) Academic Research Enhancement Awards (AREA) (R15) award for research by Dr. Heather Fritz (PI) and Dr. Malcolm Cutchin (Co-I). The award, which supports research projects at educational institutions that have not been major recipients of NIH support, is the first NIH research award to PNWU.
The project first aims to understand the key challenges older African Americans face that lie at the intersection of age and race. Then, Fritz, Cutchin, and collaborators at Wayne State University will develop videos with African American actors communicating those issues – videos that can be used in the training of future health care professionals to increase the understanding and empathy of older African American patients.
Nearly 80% of older adults have comorbid chronic conditions. However, older African Americans tend to have an earlier onset of chronic conditions, higher rates of multimorbidity, more severe disability, and worse disease outcomes compared to their European American counterparts. Health care providers play a critical role in helping older African Americans manage their chronic conditions and overcome challenges to chronic condition self-management. The literature suggests that empathetic, personalized support from providers results in higher adherence to treatment plans, better patient-provider interactions, and better patient outcomes.
Unfortunately, studies suggest that not all groups receive the same level of empathetic, supportive care. Ageism and racism are two factors that have been linked to lower quality care and the dual disadvantage of being older and being a minority, puts older African Americans at an especially high risk of experiencing suboptimal care. Even more concerning are data suggesting that empathy decreases as students progress through their medical education. Fortunately, evidence suggests that it is possible to increase empathy. One pathway to increasing empathy is through having students immerse themselves in emotional accounts of illness.
As narrative medicine has become more popular, educators have increased their use of educational videos and patient vignettes, yet the validity or effectiveness of those tools is largely unknown. Often, vignettes are simply created from a compelling patient case instead of from a broader population health perspective on shared experiences. In this new study, Fritz and team use stories collected from older African Americans in Detroit to determine the most common issues faced in chronic condition self-management that providers need to understand. In the current use of videos, students may view a video and write a reflection about it, but what is not known is if the messages that were intended to be transmitted in the video are really being ‘received’ by the student. That is something Fritz, Cutchin, and collaborators will examine with PNWU student doctor volunteers.
The longer-term goal of this project is to create and archive the series of brief videos which can be used across the various health professions programs at PNWU and beyond. Dr. Fritz explains, “We are especially excited to bring this project to PNWU. The work aligns well with the recent investments in the Office of Diversity, Equity, and Inclusion, the mission of the University, which includes a focus on medically underserved populations, and the desire to better prepare future health care providers who understand and empathize with patients whose experiences are poorly understood by the providers. As a gerontologist, it is also important that students be able to understand these issues in the context of aging, especially as many physicians lack substantive geriatric training and report holding negative opinions about older adults.”
The R15 mechanism also has a requirement that students be involved in research and that the study products contribute to building research infrastructure. Not only is the award an excellent opportunity for students to gain hands-on research experience, but once completed, the data and videos will be available for others at PNWU to use in the classroom as well as in their own research.