VCU news

By Brian McNeill

The National Institution of Nursing Research, which is part of the National Institutes of Health, has awarded a $2.4 million grant to Nao Hagiwara, Ph.D., an associate professor in the Department of Psychology in the College of Humanities and Sciences at Virginia Commonwealth University, and Peter Mende-Siedlecki, Ph.D., associate professor in the Department of Psychological and Brain Sciences at the University of Delaware, to co-lead a study on racial disparities in surgical pain.

Since persistent, untreated pain is a robust predictor of poor quality of life overall, Hagiwara and her team suggest that racial pain disparities are a critical factor contributing to larger social inequalities. The study is titled PROGRESS (Patient-provideR cOordination in surGical pain dispaRitiES Study).

“Despite decades of efforts to reduce racial pain disparities, the pain of Black patients continues to be underdiagnosed and undertreated,” Hagiwara said. “There is an urgent need to address this decades-old issue by taking an innovative approach.”

Hagiwara and her collaborators argue that prior research has made little progress in reducing racial pain care disparities because it has investigated patient and provider factors in isolation. Their project will instead focus on these factors in tandem, and importantly, will highlight the central role of patient-provider communication processes in supporting pain care.

“The overarching goal of this research is to establish the dyadic and dynamic processes underlying patient-provider communication, namely behavioral coordination, as the key mechanism underlying racial disparities in both patient-centered outcomes (e.g., pain management self-efficacy, quality of life) and clinical outcomes (e.g., pain level, prescriptions),” said Hagiwara, who has studied patient-provider communication since coming to VCU a decade ago.

“Successful pain care requires constructive patient-provider communication,” she said. “Constructive communication is both dyadic and dynamic; in the pain care context, patients express their concerns about or issues with pain, providers interpret and respond, and this back-and-forth continues until they reach an agreement.”

In focusing on real-world patient-provider interactions, the researchers hope to identify exactly what triggers disruptions in communication, at which behavioral level, by whom and in what sequence – and in a natural setting.

“Once we identify specific aspects of behavioral coordination associated with racial disparities in pain care and outcomes, we can design interventions to help providers learn how to detect and proactively avoid potential triggers of disruptions in coordination during their communication with patients,” Hagiwara said.

In addition to Hagiwara and Mende-Siedlecki, the study’s researchers include Shawn Jones, Ph.D., assistant professor in the Department of Psychology at VCU; Emily Rivet, M.D., associate professor in the School of Medicine at VCU; Amelia Grover, M.D., professor in Department of Surgery’s Division of Surgical Oncology at VCU; Brian Eiler, Ph.D., assistant professor of psychology, at Davidson College; and Lindsay Bryant, a community health educator in Richmond.