Summaries of Independent Scientist (K) Awards

Beach, Mary C

Institution: Johns Hopkins University, Baltimore, MD
Grant Title: Patient-Centeredness in Care of Vulnerable Populations
Grant Number: K08 HS013903
Duration: 5 years (2003-2008)
Total Award: $647,600

Project Description: The three goals of this project are:

1. To evaluate the impact of patient literacy on patient participation in care and patient-physician communication.
2. To test a multidimensional model of vulnerability to poor interpersonal treatment and to evaluate health care system features that moderate the relationship between vulnerability and poor interpersonal treatment.
3. To develop an instrument measuring cultural competence from the patient's perspective.

Career Goals: Dr. Beach is an Assistant Professor in the Department of Medicine, Division of General Internal Medicine, at the Johns Hopkins University. This research will further develop her as a leader in health services research and health policy focused on disparities in healthcare quality and patient-centeredness for vulnerable populations. Building on her background in internal medicine, bioethics and health policy, she hopes to develop additional skill through:

• Coursework in methodology.
• Interaction with a multidisciplinary sponsorship team, including experts in health services research, patient-physician communication, cross-cultural communication, and bioethics.
• A series of supervised research projects.

Progress to Date: Dr. Beach has completed Web-based research compliance courses of Johns Hopkins University School of Medicine in Human Subjects Research Training, training in the Health Insurance Portability and Accountability (HIPAA), and regularly attends academic research conferences. Baseline data collection has been completed, analysis is underway, and manuscripts have been written and published. Dr. Beach has disseminated her work through oral presentations at national and international conferences. Dr. Beach has served as an expert advisor for the American Medical Association's Ethical Force Program in Patient-Centered Communication, the Commonwealth Fund's Cultural Competence Roundtable, and the National Committee on Quality Assurance's Cultural Competence in Patient-Centered Care Initiative. She has been invited to several institutions as a Visiting Scholar (Indiana University) and to give talks in the areas of respect, patient-physician communication, and cultural competence (Mount Sinai School of Medicine, University of Rochester, University of Nebraska), and also to speak on patient-centeredness at the Robert Wood Johnson Foundation's 2nd Annual National Disparities Conference.

Future Plans: Dr. Beach will continue to participate in the Patient-Physician Partnership to Improve HBP Adherence study, where she gains experience in methods related to randomized clinical trials, analyze data related to the research, and complete cognitive interviews by the spring of 2005. Dr. Beach will continue to develop her research examining disparities in and the importance of patient-centeredness among patients with HIV and sickle cell disease. Academic training in research methods will be pursued and grant writing will be developed.

Highlights and Specific Accomplishments:

• Associate Editor, Journal of General Internal Medicine.
• Congressional Fellow in Health Policy, Office of Senator Hillary Rodham Clinton.
• Fellowship, The Greenwall Fellowship Program in Bioethics and Health Policy Bioethics Institute, Johns Hopkins University School of Public Health.
• Kennedy Institute of Ethics, Georgetown University.

K-Generated Publications:

• Beach MC, Halpern J, Meredith L, et al. Physicians' Conceptions of Responsibility to Individual Patients and Social Justice in Health Care. Annals of Family Medicine 2005;3(1):53-9.
• Beach MC, Roter D, Levinson W, et al. What do Doctors Tell Patients about Themselves? A Qualitative Analysis of Physician Self-Disclosure. Journal of General Internal Medicine 2004;19(4):911-6.
• Beach MC, Cooper LA, Robinson KA, et al. Strategies for Improving Minority Healthcare Quality: Evidence Report/Technology Assessment No. 90 (Prepared by Johns Hopkins University Evidence-based Practice Center, Baltimore, MD) AHRQ Publication No. 04-E008-02. Rockville, MD: Agency for Healthcare Research and Quality, January 2004.
• Beach MC, Asch DA, Jepson C, et al. Public Response to Cost-Quality Tradeoffs in Clinical Decisions. Medical Decision Making 2003;23(5):369-78.
• Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. What Explains Racial and Ethnic Differences in Patient Ratings of Cultural Competence? Journal of General Internal Medicine 2004;19(2):101-10.
• Beach MC, Morrsion RS. Response Letter to Dr. Muriel Gillick. Journal of American Geriatric Society 2004;52(5):850-1.
• Beach MC, Roter D, Frankel R, et al. Is Physician Self-Disclosure Related to Patient Evaluation of Office Visits? Journal of General Internal Medicine 2004;19(4):905-10.
• Cooper LA, Beach MC, Clever SL. Participatory decisionmaking in the Medical Encounter and its Relation to Patient Literacy. In Understanding Health Literacy: Implications for Medicine and Public Health. American Medical Association Press, 2005.
• Beach MC, Price EG, Gary TL, et al. Cultural Competence: A Systematic Review of Health care Provider Educational Interventions. Medical Care 2005;43(4):356-73.
• Beach MC, Saha S. Free to Be You and Me? Balancing Professionalism, Culture, and Self-Expression. Journal of General Internal Medicine 2005;20(3):312-3.
• Beach MC, Faden R. Commentary: Evidence-based medicine and ethics. Clinical Evidence 2005.
• Price EG, Beach MC, Gary TL, et al. A methodologic review of studies evaluating cultural competence training of health professionals. Academic Medicine 2005 June;80(6):578-86.
• Beach MC, Sugarman J, Johnson RL, et al. Do patients treated with dignity report higher satisfaction, adherence and receipt of preventive care? Annals of Family Medicine 2005 Jul-Aug;3(4):331-8.
• Reed D, Price EG, Windish DM, et al. Challenges and recommendations in systematic reviews: The reporting and reviewing of educational intervention studies. Annals of Internal Medicine. 2005 Jun 21;142(12 Pt 2):1080-9.
• Beach MC. Physician self-disclosure and lower satisfaction among primary care patients: What should we do now? Medical Encounter. 2005;19:30-1.
• Duggan PD, Geller G, Cooper LA, Beach MC. The moral nature of patient-centeredness: Is it 'just the right thing to do?' Patient Education and Counseling 2005 Dec 12.
• Beach MC, Inui T. Relationship-centered care: A constructive reframing. Journal of General Internal Medicine 2006 Jan;21 Suppl 1:S3-8.
• Cooper LA, Beach MC, Johnson R, Inui T. Delving below the surface: Understanding how race and ethnicity influences relationships in healthcare. Journal of General Internal Medicine 2006 Jan;21 Suppl 1:S21-7.
• Beach MC, Hill-Briggs F, Cooper LA. Racial and ethnic differences in receipt and use of health information in encounters between patients and physicians. Medical Care 2006;44(2):97-9.
• Kutner JS, Westfall JM, Morrison EH, Beach MC, et al. Facilitating collaboration among academic generalist disciplines: A call to action Annals of Family Medicine 2006 Mar-Apr;4(2):172-6.
• Beach MC, Keruly J, Moore RD. Is the quality of the patient-provider relationship associated with better adherence and improved health outcomes for patients with HIV? Journal of General Internal Medicine (in press).
• Beach MC, Gary TL, Price EG, et al. Improving health care quality for racial/ethnic minorities: A systematic review of the best evidence regarding provider and organization interventions. BMC Public Health 2006;6:104.
• Beach MC. What is patient-centeredness? Commissioned by and prepared for the Patient-centered Communication Initiative, Institute for Ethics, American Medical Association, Chicago, IL.
• Beach MC, Saha S, Cooper LA. Patient-centeredness and cultural competence: Their relationship and role in healthcare quality. Commissioned by and prepared for The Commonwealth Fund, New York, NY.

AHRQ Research Portfolios:  Socio-Economics of Health Care; Training; Care Management.
AHRQ Goals:  Safety and Quality

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