# Developing Novel Linguistic Analytic Methods to Optimize Relationship Quality and Equity in HIV Care

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2021 · $245,625

## Abstract

Project Summary
Evidence across multiple disease areas including HIV care demonstrates that higher quality patient-clinician
communication and relationships substantially improves patient health outcomes. It is also well-established that
racial and ethnic minorities - African Americans in particular - have consistently lower rates of being engaged in
HIV care, be prescribed and adhere to antiretroviral medications, and have higher morbidity and mortality.
Evidence suggests that these disparities may rise in part from racial/ethnic differences in relationships and
communication between HIV clinicians and patients, which are a potentially remediable source of healthcare
inequities. The goal of our project is to develop innovative, valid and scalable measurement and analytic
approaches for better understanding of patient-physician interactions that can guide development of
interventions to improve the quality of care delivered.
This proposal focuses on two innovative features of communication: linguistic style matching (LSM) and linguistic
accommodation. LSM is the tendency of participants to use a common vocabulary and speech structure, while
linguistic accommodation is the process by which participants in a conversation adjust their language according
to the speech style of the other participant. Although there are currently many methods for measuring aspects
of patient-clinician communication, no studies to date have explored the role of LSM and linguistic
accommodation. Both hold promise as potential mechanisms by which greater social/cultural distance can result
in lower quality relationships and outcomes. Accordingly, our specific aims are: (1) Apply computerized text
analysis tools to transcripts of clinician-patient interactions to generate novel measures of LSM and linguistic
accommodation in HIV care, (2) Evaluate the convergent and predictive validity of LSM and linguistic
accommodation to HIV outcomes, and (3) Qualitatively explore examples of visits with high and low LSM and
with provider linguistic style dimensions associated with high and low relationship quality.
A better understanding of the dynamics of physician and patient interaction in HIV care is necessary to inform
continued improvements in HIV care quality and equity. The innovative approach outlined here can: 1) elucidate
mechanisms by which HIV clinicians can communicate more effectively and reduce racial/ethnic disparities in
HIV outcomes, 2) provide initial validity evidence for a novel communication analytic methods, 3) expand the
cost-effectiveness and scale of communication analysis studies of physician-patient interaction, and 4) provide
guidance on building real-time feedback systems for HIV clinicians to improve their interactions over time.

## Key facts

- **NIH application ID:** 10252171
- **Project number:** 1R21MH126714-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** MARY CATHERINE BEACH
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $245,625
- **Award type:** 1
- **Project period:** 2021-06-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10252171

## Citation

> US National Institutes of Health, RePORTER application 10252171, Developing Novel Linguistic Analytic Methods to Optimize Relationship Quality and Equity in HIV Care (1R21MH126714-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10252171. Licensed CC0.

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