# Addressing Contextual Factors in Chronic Disease Management in Minority Older Adults through Photo-based Patient-Clinician Communication

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $174,798

## Abstract

PROJECT SUMMARY AND ABSTRACT
By 2050, 42% of the older U.S. population will be racial/ethnic minorities. Older minorities bear a substantial
burden of multiple chronic conditions (MCC) and receive poorer quality of chronic disease management.
Patient-clinician communication barriers are important contributors to disparities in care and outcomes of MCC.
In particular, clinical visit communication about the context of people’s lives (i.e., contextual factors such as
medication use, dietary habits, fall risk and social support) optimally informs MCC management and is vital to
delivering patient-centered care. Yet, few patient-clinician communication interventions have included diverse
older adults with MCC, and most do not address the interactions of aging, MCC and contextual factors that
enhance or reduce health. A common scenario is the minority older adult with diabetes and concurrent
comorbid conditions. The burden of self-management tasks related to diabetes (e.g., checking glucose, taking
medications, adhering to diet) while simultaneously following care plans for other conditions can be
overwhelming, particularly when care plans do not account for the context of patients’ daily lived experiences.
The overarching goal of this proposal is to overcome disparities in patient-clinician communication among older
minorities with MCC by developing a patient-centered technology-based communication intervention called
Photo+Care. The premise of Photo+Care is that a picture is worth a thousand words, meaning that photos can
promote efficient information exchange and activate patients to communicate their lived experiences to their
clinicians, so they can develop patient-centered care plans together. Using smartphone cameras as a tool,
Photo+Care will elicit and integrate 4 contextual factors (medication use, dietary habits, fall risk and social
support) into primary care for older minority adults with MCC. Photo+Care will consist of a patient component,
comprising: 1) brief training on how to take photos using a smartphone; and 2) standardized, structured and
open-ended prompts to guide what kind of photos to take to describe 1 of the 4 contextual factors. The clinician
component includes brief training on: 1) how to respond to photos shared by patients; and 2) how to discuss
contextual factors elicited by the photos. The patient-clinician component is when patients briefly share select
photos with clinicians during a clinic visit. The career goal of the candidate, Dr. Jane Jih, is to be a leader in the
national mission to achieve health equity and a research expert on health disparities among older adults. Her
short-term goals are to gain additional skills necessary to develop and test patient-centered interventions that
improve outcomes for multiethnic and linguistically diverse older adults. To support her career development,
Dr. Jih has assembled an exceptional multidisciplinary mentoring team including Dr. Christine Ritchie, a
geriatrician with MCC...

## Key facts

- **NIH application ID:** 10370303
- **Project number:** 5K23MD015089-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Jane Jih
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $174,798
- **Award type:** 5
- **Project period:** 2021-03-11 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10370303

## Citation

> US National Institutes of Health, RePORTER application 10370303, Addressing Contextual Factors in Chronic Disease Management in Minority Older Adults through Photo-based Patient-Clinician Communication (5K23MD015089-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10370303. Licensed CC0.

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