Summaries of Independent Scientist (K) Awards

Beach, Mary C

Institution: Johns Hopkins University (JHU), Baltimore, MD
Grant Title: Patient-Centeredness in Care of Vulnerable Populations
Grant Number: K08 HS013903
Duration: 5 years (2003-2008)
Total Award: $647,600

Project Description: The three goals of this project were to:

1. Evaluate the impact of patient literacy on patient participation in care and patient-physician communication.
2. Test a multidimensional model of vulnerability to poor interpersonal treatment and to evaluate health care system features that moderate the relationship between vulnerability and poor interpersonal treatment.
3. Develop an instrument measuring cultural competence from the patient's perspective.

Career Goals: Dr. Beach is an Associate Professor in the Department of Medicine, Division of General Internal Medicine, at the Johns Hopkins University. She received her MD from Mount Sinai School of Medicine where she also did her residency. This was followed by a Fellowship in Internal Medicine at Johns Hopkins where she earned her MPH. This K award helped her develop as a leader in health services research and health policy focused on disparities in healthcare quality and patient-centeredness for vulnerable populations. Building on her background in internal medicine, bioethics and health policy, she was able to develop additional skill through:

• Coursework in methodology.
• Interaction with a multidisciplinary sponsorship team, including experts in health services research, patient-physician communication, cross-cultural communication, and bioethics.
• A series of supervised research projects. 

Progress to Date: This grant has been completed. In her study of health literacy, Dr. Beach found patients did not differ with regard to their desired or perceived level of involvement based on health literacy. In audiotaped analysis, however, patients with low health literacy asked significantly fewer questions and gave less information to physicians. Dr. Beach became a nationally-recognized expert in the area of patient-centered care for vulnerable populations.

Future Plans: Dr. Beach will conduct data analysis on her HIV study and implement an intervention aimed at improving communication. She will continue drafting manuscripts for publication and participating in the Patient-Physician Partnership to Improve HBP [High Blood Pressure] Adherence Study.

Highlights and Specific Accomplishments:

• Associate Editor, Journal of General Internal Medicine.
• Congressional Fellow in Health Policy, Office of Senator Hillary Rodham Clinton.
• Fellowship, The Greenwall Fellowship Program in Bioethics and Health Policy Bioethics Institute, Johns Hopkins University School of Public Health.
• Kennedy Institute of Ethics, Georgetown University.
•  Visiting Scholar at Indiana University.

K-Generated Publications: (selected):

Beach MC, Halpern J, Meredith L, Wells K, Ford DE. Physicians' conceptions of responsibility to individual patients and social justice in health care. Annals of Family Medicine 2005. 3(1):53-9.

Beach MC, Roter D, Levinson W, Ford DE, Frankel R. What do doctors tell patients about themselves? A qualitative analysis of physician self-disclosure. Journal of General Internal Medicine 2004.19(4):911-16.

Beach MC, Asch DA, Jepson C, Hershey JC, et al. Public response to cost-quality tradeoffs in clinical decisions. Medical Decision Making 2003. 23(5):369-78.

Johnson RL, Saha S, Arbelaez JJ, Beach MC, Cooper LA. What explains racial and ethnic differences in patient ratings of cultural competence? Journal of General Internal Medicine 2004. 19(2):101-10.

Beach MC, Morrsion RS. Response letter to Dr. Muriel Gillick. Journal of the American Geriatric Society 2004. 52(5)850-51.

Beach MC, Roter D, Frankel R, et al. Is physician self-disclosure related to patient evaluation of office visits? Journal of General Internal Medicine 2004.19(4):905-10.

Beach MC, Price EG, Gary TL, Gozu A, et al. Cultural competence: A systematic review of health care provider educational interventions. Medical Care 2005. 43(4):356-73.

Beach MC, Saha S. Free to be you and me? Balancing professionalism, culture, and self-expression. Journal of General Internal Medicine 2005. 20(3)312-13.

Price EG, Beach MC, Gary TL, Gozu A, et al. A methodologic review of studies evaluating cultural competence training of health professionals. Academic Medicine 2005. 80(6):578-86.

Beach MC, Sugarman J, Johnson RL, Arbelzez JJ, et al. Do patients treated with dignity report higher satisfaction, adherence and receipt of preventive care? Annals of Family Medicine 2005. 3(4):331-38.

Beach MC. Physician self-disclosure and lower satisfaction among primary care patients: What should we do now? Medical Encounter 2005;19:30-1.

Beach MC, Inui T. Relationship-centered care: A constructive reframing. Journal of General Internal Medicine 2006. Jan;21 Suppl 1:S3-8.

Cooper LA, Beach MC, Johnson R, Inui T. Delving below the surface: Understanding how race and ethnicity influences relationships in healthcare. Journal of General Internal Medicine 2006. Jan:21 Suppl 1:S21-7.

Beach MC, Hill-Briggs F, Cooper LA. Racial and ethnic differences in receipt and use of health information in encounters between patients and physicians. Medical Care 2006. 44(2):97-9.

Kutner JS, Westfall JM, Morrison EH, Beach MC, et al.  Facilitating collaboration among academic generalist disciplines: A call to action. Annals of Family Medicine 2006. 4(2)172-76.

Beach MC, Keruly J, Moore RD. Is the quality of patient-provider relationship associated with better adherence and improved health outcomes for patients with HIV? Journal of General Internal Medicine 2006. 21(6)661-65.

Beach NC, Gary TL, Price EG, Gozu A, Robinson KA, et al. Improving health care quality for racial/ethnic minorities: A systematic review of the best evidence regarding provider and organization interventions. BMC Public Health 2006. 6:104.

Beach MC, Roter DL, Wang N, Duggan P, Cooper LA. Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Education and Counseling 2006. 62(3):347-54.

Beach MC, Rosner M, Cooper LA, et al. Can patient-centered attitudes reduce racial/ethnic disparities in care? Academic Medicine 2007. 82(2):193-98.

Beach MC, Duggan P, Cassell CK, Geller G. What does 'respect' mean? Exploring the moral obligation of health professionals to respect patients. Journal of General Internal Medicine 2007. 22(5):692-95.

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