Lauren Hamel, Ph.D., assistant professor of Oncology for the Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute, has received a two-year National Institute of Health/National Institute of Minority Health and Health Disparities R21 research grant of $429,658 to study nonverbal actions in the relationships between cancer patients and physicians of differing races.
Dr. Hamel, also a member of the Karmanos Population Studies and Disparities Research Program, investigates patient-physician communication and how it contributes to racial disparities in cancer treatment and mortality. Her study is titled “Nonverbal Synchrony as a Behavioral Marker of Patient and Physician Racial Attitudes and Predictor of Outcomes of Clinical Interactions.”
The Institute of Medicine report, “Unequal Treatment,” and other research suggests that the quality of patient-physician communication during racially discordant (black patient, non-black physician) clinical interactions is much poorer than in racially concordant clinical interactions. Racially discordant interactions constitute about 80 percent of black patients’ clinical interactions, and poorer quality communication in these interactions likely contributes to racial treatment disparities.
Earlier research, including research conducted at WSU and Karmanos, finds that racially discordant medical interactions are less positive and productive than racially concordant interactions. Patient and physician racial attitudes (e.g., patient suspicion about the medical care blacks receive, physician implicit racial bias against blacks) also affect communication during interactions.
“Racial attitudes are largely expressed through subtle nonverbal behaviors,” Dr. Hamel said. “However, prior research has not focused on these behaviors or examined the dynamic, reciprocal way they are expressed. This study will address this gap in understanding by examining nonverbal synchrony, or the coordination of physical movement, which research has shown reflects pre-interaction attitudes and predicts post-interaction outcomes.”
Dr. Hamel and her colleagues will investigate nonverbal synchrony in both racially concordant and racially discordant video-recorded cancer clinical interactions using objective automated software that continuously monitors the synchrony of movement between the patient and the physician.
“This study is significant because its findings will improve knowledge of differences in nonverbal communication in racially concordant and racially discordant oncology interactions; how racial attitudes are communicated during oncology interactions; and how subtle nonverbal communication affects interaction outcomes and contributes to treatment disparities,” Dr. Hamel said. “This knowledge provides information that can be used in medical education and evaluations of treatment disparity interventions.
“This study is innovative because it examines an unexplored and powerful channel of communication using innovative methods to assess the often complex, dynamic and reciprocal process of patient-physician communication.”
The award number is 1R211MD011766-01A1.