# Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation

> **NIH NIH K01** · DUKE UNIVERSITY · 2024 · $150,562

## Abstract

Blacks with non-valvular atrial fibrillation (NVAF) are less likely to receive oral anticoagulants (OAC) for stroke
prevention compared with Whites. This is notable given that Blacks have a 3-fold greater risk of NVAF-related
ischemic stroke compared to Whites. My long-term goal is to reduce racial disparities in arrhythmia (defined as
an abnormal heart rhythm) care. My goal in applying for a Mentored Career Development Award to Promote
Faculty Diversity in Biomedical Research is to acquire the research skills and hands-on experience necessary
to become a productive, independent, clinician-scientist. My research focuses on addressing racial disparities in
the use of OAC in patients with NVAF. Candidate and Mentors: I am an Assistant Professor of Medicine at
Duke University’s School of Medicine where I practice as an cardiac electrophysiologist. My primary mentor, Dr.
Kevin Thomas, has expertise in healthcare disparities, specifically the contributors to lower quality of health care
delivery and outcomes among racial and ethnic minority populations. Research and Training: The goal of this
research proposal is to develop a patient decision support tool aimed at facilitating shared decision making,
improving decision quality, and increasing the uptake of OAC in Blacks with NVAF. Shared decision making,
aided through the use of patient decision support tools, has been associated with improved outcomes including
increased knowledge, less decisional conflict, and increased uptake of therapeutic interventions. Unfortunately,
Blacks are more likely to experience non-participatory decision making than non-racial and ethnic minority
populations. In this proposal, I will: 1) conduct interviews among Black and White patients with NVAF and
clinicians to understand the barriers and facilitators toward participating in shared decision making regarding use
of OACs; 2) develop and iteratively evaluate a patient decision support tool; and 3) conduct a pilot study to
assess the feasibility and acceptability of a patient decision support tool to facilitate shared decision making. The
training plan will prepare me for a career aimed at addressing racial disparities in arrhythmia care and will include
education in 1) implementation science to promote the adoption of our patient decision support tool in clinical
practice; 2) accruing skills in the design and testing of patient decision support tools; and 3) design of clinical
trials to assess the efficacy of our intervention. This research will provide data to support a R01 proposal to test
the efficacy of a patient decision support tool to improve shared decision making, decision quality, and potentially
increase the use an adherence of OAC in Blacks in a multisite randomized clinical trial. Summary: The proposed
research will lead to the development of a patient decision support tool intervention used to facilitate shared
decision making in Blacks with NVAF, improve decision quality, and potentially increase the upta...

## Key facts

- **NIH application ID:** 10914672
- **Project number:** 5K01HL159041-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Larry R Jackson
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $150,562
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914672

## Citation

> US National Institutes of Health, RePORTER application 10914672, Shared Decision-Making to Reduce Racial Disparities in Oral Anticoagulation Use in Patients with Non-Valvular Atrial Fibrillation (5K01HL159041-04). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10914672. Licensed CC0.

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