Abstract
This research aims to develop and pilot-test a patient-centered clinical decision support (PC CDS) web application specifically for Chinese Americans with chronic rhinosinusitis (CRS). CRS, which affects about 16% of U.S. adults annually, significantly impacts quality of life (QOL). Endoscopic sinus surgery (ESS) is a recommended treatment for those unresponsive to medical therapy; however, Chinese Americans face unique barriers that result in surgical hesitancy and suboptimal outcomes. A previous study at USC showed that nonChinese American patients were significantly more likely to undergo ESS than Chinese Americans, highlighting a critical disparity (Odds Ratio = 7.92; 95% CI: 2.95–21.28; p < 0.001). To address this, the proposed PC CDS will integrate culturally sensitive components tailored to Chinese Americans, including educational resources, AIassisted patient narratives, and a patient-provider communication feature in a bilingual decision aid.
The project has three main aims: (1) develop the PC CDS to facilitate shared decision-making (SDM) between patients and clinicians, aiming to reduce surgical hesitancy and improve outcomes; (2) recruit 50–60 Chinese American CRS patients from USC clinics in Los Angeles for a randomized controlled trial of feasibility study comparing usual care with the PC CDS intervention; and (3) assess patient healthcare journey outcomes, and acceptability and experience with the PC CDS through pre- and post-intervention evaluations using both quantitative and qualitative methods.
The research team, led by experts in health technology and rhinology, will work with a Chinese American Patient Advisory Group (CAG) to ensure cultural relevance and community engagement. This project will enable us to seek further funding from the Agency for Healthcare Research and Quality and the NIH’s National Institute on Minority Health and Health Disparities to expand its focus on health disparities and PC CDS strategies.