Communication Quality During Family Meetings In The Intensive Care Unit: How Does Quality Impact Health Outcomes?

Abstract The long-term goal of this research is to provide data to inform the tailored, theoretically grounded and evidence-based development of communication interventions to support family members in the ICU. The goal of this R01 proposal is to test and refine a leading conceptual model that relates communication quality to healthcare outcomes (The Street Conceptual Model) in the new post- pandemic world, with an emphasis on communication needs for underserved communities (Black, Hispanic, and rural communities). The Street Conceptual Model posits both direct and indirect pathways that link communication to health outcomes; although, surprisingly, the relationships of the variables in the model have not been formally quantified or systematically examined in a rigorous and well-powered longitudinal cohort study (even before the pandemic). Further, issues related to social determinants of health (e.g. rurality) have been understudied, with very little research focusing on communication with family members in rural ICU settings. Testing and refining the Street Conceptual Model is both timely and important because it will allow stronger delineation of the mechanism of action to inform design (or re-design) communication interventions that may help improve communication during goals of care conversations in the ICU. Such efforts are critical if we are to address post-COVID-19 damages to the therapeutic alliance and healthcare system distrust and continue ongoing efforts to improve psychological and medical health outcomes for family members of ICU patients. These damages have been particularly devastating for those with under-represented status, including those living in rural areas and those of racial or ethnic background (CITE).