# Improving patient-provider communication to reduce mental health disparities

> **NIH VA IK2** · RLR VA MEDICAL CENTER · 2020 · —

## Abstract

Reviews of disparities in the VA healthcare system showed that significant racial and ethnic healthcare
disparities persist across all sections in the VA, which affect health care costs, quality of care, patient
satisfaction, and the health of Veterans. Patient-provider communication has been identified as a significant
contributor to health and mental healthcare disparities. Specifically, lower level of participation in shared
decision-making (SDM) among racial and ethnic minority patients and providers’ lower level of empathy
towards minority patients contribute to racial and ethnic differences in patient-provider communication. Despite
robust evidence documenting the important role of poor communication in healthcare disparities, few
interventions have been developed to improve patient-provider communication among minority groups.
Moreover, interventions to reduce mental healthcare disparities are lacking.
This study seeks to improve patient-provider communication, specifically minority Veterans’ participation in
SDM to reduce mental health disparities. SDM is a patient-provider communication strategy, widely recognized
for engaging patients in their own healthcare and is associated to positive patients’ health outcomes. Current
efforts to improve patients’ participation in SDM, especially in mental healthcare, are limited by lack of
understanding and integration of patients’ social contexts in their treatment, such as their lived experiences –
an important barrier to address, and inadequate attention to precursors to SDM such as patient engagement.
Therefore, the primary objectives of this study are to 1) (Aim 1) adapt the George Washington University
(GWU) patient navigation intervention, a health disparity evidence-based intervention in cancer care, to
increase minority Veterans’ participation in SDM; 2) (Aim 2) refine and evaluate the intervention; and 3) (Aim 3)
use systems redesign methods to conduct pre-implementation planning to facilitate effective intervention
implementation in VA mental health settings.
We will use an ecological framework that emphasizes sociocultural contexts in health communication and the
Consolidated Framework for Implementation Research (CFIR) to guide the development and implementation
of the proposed intervention. To accomplish Aim 1, we will elicit iterative feedback from Veterans, providers,
peers, and other stakeholders from multiple VA facilities within VISN 10, in conjunction with an ethnographic
study of Veterans and peers in mental health services. In Aim 2, we will evaluate the intervention at one site on
a sample of (N=50) Veterans and using a randomized controlled trial design that will consist of an experimental
(intervention) and control (treatment as usual) groups. We will refine the intervention based on this pilot study,
and lay the foundation for a multi-sited, hybrid I randomized controlled trial (RCT) to determine its effectiveness
in improving patient activation, patient engagement, and SDM...

## Key facts

- **NIH application ID:** 9696672
- **Project number:** 5IK2HX002283-02
- **Recipient organization:** RLR VA MEDICAL CENTER
- **Principal Investigator:** JOHANNE ELIACIN
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9696672

## Citation

> US National Institutes of Health, RePORTER application 9696672, Improving patient-provider communication to reduce mental health disparities (5IK2HX002283-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9696672. Licensed CC0.

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