Community Engagement for Systemic Racism

(AACS Trial)

Recruiting at 2 trial locations

Overseen By Tametria V Heard, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Disqualifiers: Hospice care, Paid sitter, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment AA Communities Speak for addressing systemic racism?

The Presence 5 for Racial Justice (P5RJ) study shows that improving communication between healthcare providers and Black patients can help address racism in healthcare. This approach, which includes listening carefully and acknowledging socio-political factors, may support the goals of AA Communities Speak by fostering trust and empowerment in Black communities. ^{1 2 3 4 5}

How does the treatment in the Community Engagement for Systemic Racism trial differ from other treatments for systemic racism?

This treatment is unique because it focuses on creating safe dialogues between people of different races to address systemic racism, unlike traditional approaches that may not emphasize direct communication and shared learning. It involves engaging individuals in discussions to examine unconscious biases and promote awareness, aiming for systemic change through education and reflection. ^{6 7 8 9 10}

What is the purpose of this trial?

African Americans are less likely to receive quality end-of-life (EoL) care. Addressing disparities in EoL care will need efforts to support a better understanding of African American patients' EoL cultural values and preferences for EoL communication and the impact of historical and ongoing care delivery inequities in healthcare settings. Our proposed "Caring for Older African Americans" training program is designed to empower clinicians to improve goal-concordant EoL care delivery by using community-developed storytelling videos to create empathy with experiences of racism in EoL care, guidelines for culturally concordant EoL care delivery, and an implicit bias recognition and management training to mitigate bias in goals of care communication.

Research Team

Jennifer Tjia, MD, MSCE

Principal Investigator

University of Massachusetts, Worcester

Eligibility Criteria

This trial is for African American individuals aged 60 or older, who are non-Hispanic/Latino and speak English. It includes those with serious illnesses like cancer or heart disease, bereaved family members of such patients, and pastors. Participants must have a certain level of cognitive function (Callahan score ≥4) and be able to complete surveys.

Inclusion Criteria

I am a 60+ year old African American who recently lost a loved one and can complete surveys.

I am over 18, speak English, live in a community, and care for someone with a serious illness without pay.

I am a pastor, 18 or older, and identify as African American, White, Non-Hispanic or Latino.

Exclusion Criteria

For Family member eligibility in Aim 3: Cannot be a paid 'sitter'

For Person with serious illness in Aim 1.1: Cannot be receiving hospice care

For Bereaved Family Member in Aim 1.1: Cannot be a paid 'sitter'

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-intervention (Control)

Clinician clusters undergo a pre-intervention period before the training program begins

up to 3 months

Intervention

Clinicians receive the African American Communities Speak (AACS) Education Intervention, including training on culturally concordant care and implicit bias management

Varies by cluster start date

Post-intervention (Exposure)

Clinician clusters undergo a post-intervention period to assess the impact of the training program

up to 3 months

Follow-up

Participants are monitored for the effectiveness of the intervention on therapeutic alliance and goal-concordant care

up to 3 months after intervention

Treatment Details

Interventions

• AA Communities Speak

Trial Overview The 'Caring for Older African Americans' program aims to train healthcare professionals using storytelling videos about racism in end-of-life care, cultural guidelines, and bias management training to improve communication and care delivery.

Participant Groups

Group I: Clinician Trainees- Cluster 4 Experimental Treatment 1 Intervention

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Group II: Clinician Trainees- Cluster 3 Experimental Treatment 1 Intervention

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Group III: Clinician Trainees- Cluster 2 Experimental Treatment 1 Intervention

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period

Group IV: Clinician Trainees- Cluster 1 Experimental Treatment 1 Intervention

Within each participating institution, clinician clusters are randomized to 1 of 4 start date training times for the African American Communities Speak (AACS) Education Intervention. Each arm has a pre-intervention (control) period and a post-intervention (exposure) period.

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Montefiore Medical Center

Collaborator

Trials

468

Recruited

599,000+

University of California, San Francisco

Collaborator

Trials

2,636

Recruited

19,080,000+

University of Massachusetts, Worcester

Collaborator

Trials

372

Recruited

998,000+

References

1. United States pubmed.ncbi.nlm.nih.gov

Presence for racial justice: disrupting racism through physician-patient communication. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Anti-racism and substance use treatment: Addiction does not discriminate, but do we? [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Alcoholics anonymous affiliation at treatment intake among white and black Americans. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

A Health System Framework for Addressing Structural Racism: Mass General Brigham's United Against Racism Initiative. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Dismantling institutional racism: theory and action. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Listen and Change [2022]

7. England pubmed.ncbi.nlm.nih.gov

Tackling racism as a "wicked" public health problem: Enabling allies in anti-racism praxis. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Perspectives Against Racism: educational and socialization efforts at the departmental level. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Race talk: the psychology of racial dialogues. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Sharing Our Stories and Holding Our Past to Task. [2021]