# Targeting Bias to Reduce Disparities in End of Life Care (BRiDgE)

> **NIH NIH K23** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2024 · $167,184

## Abstract

7. Project Summary/Abstract
 The population of adults over 65 is becoming more racially and ethnically diverse. Despite
improvements in the quality of end-of-life care over the past two decades, significant disparities remain. Black
patients and their families report poorer quality end-of-life care, are more likely to receive ineffective and
burdensome care and are less likely to enroll in hospice at end of life. Effective patient-doctor communication
is crucial for improving the quality of end-of-life care. Physicians, who are mainly White and Asian in the United
States, are less likely to discuss end-of-life care and display poorer communication styles with Black patients.
Implicit bias refers to unconscious, automatic attitudes or stereotypes. Physician implicit racial bias is
widespread and associated with communication behavior in some clinical situations. The effects of this bias on
communication in the end-of-life setting have not been studied.
 The proposed combination of didactics and mentored clinical investigation will allow Dr. Chuang to build
on her existing quantitative and qualitative skills by designing simulated patient encounter measures of
communication behavior, developing expertise in community engaged research, and developing a clinical trial.
Mentored investigation will occur under the instruction of three senior investigators with expertise in serious
illness communication, health disparities and community engaged research, and palliative care. The specific
aims include: 1) to test the impact of implicit bias and stereotyping on clinician communication behaviors, 2) to
identify elements of end-of-life communication that are most important to Black patients facing serious illness in
an urban community, and 3) to assess the feasibility, acceptability and potential efficacy of an end-of-life
communication training intervention for clinicians to mitigate the effects of implicit bias and stereotyping.
 Dr. Chuang will assess the relationship between implicit bias, stereotyping and communication in a
simulated setting using validated measures of implicit bias and communication behaviors. She will obtain
feedback from physicians on their communication and implicit bias training needs and preferences. She will
design, implement and analyze in-depth caregiver focus group interviews to inform the main intervention.
Finally, she will design and implement an implicit bias and stereotyping mitigation and communication skills
training intervention for physicians incorporating evidence-based bias mitigation techniques and caregiver
input, which will be piloted in a small randomized controlled trial. This will directly lay the foundation for an R-01
application for a multi-site randomized controlled trial to test how the intervention leads to changes in patient-
and family-centered outcomes as well as clinical and healthcare utilization outcomes. This training in advanced
qualitative and quantitative methods will produce a confident patie...

## Key facts

- **NIH application ID:** 10839342
- **Project number:** 5K23MD015277-04
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Elizabeth Chuang
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $167,184
- **Award type:** 5
- **Project period:** 2021-09-18 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10839342

## Citation

> US National Institutes of Health, RePORTER application 10839342, Targeting Bias to Reduce Disparities in End of Life Care (BRiDgE) (5K23MD015277-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10839342. Licensed CC0.

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