Summaries of Independent Scientist (K) Awards

Mangione-Smith, Rita

Institution: University of Washington, Seattle
Grant Title: Doctor-Parent Communication and Antibiotic Over-Prescribing
Grant Number: K02 HS013299
Duration: 5 years (2002-2007)
Total Award: $473,850

Project Description: This project had four main goals:

1. Explore what systematic communication behaviors parents use to express their desires for antibiotic prescriptions.
2. Examine what parent communication behaviors lead to both accurate and inaccurate physician perceptions of parental expectations of antibiotics.
3. Determine if physician perceptions of parent expectations are associated with antibiotic prescribing for viral conditions and higher rates of assigning bacterial diagnoses to upper respiratory infections.
4. Determine if specific physician communication behaviors are associated with increased parental satisfaction when expectations for unnecessary antibiotics are not fulfilled.

Career Goals: Dr. Mangione-Smith received her M.D. from Wayne State University in Detroit and did her pediatric residency at Children's Memorial Medical Center at Northwestern University in Chicago.  She was a Robert Wood Johnson Clinical Scholar at the University of California, Los Angeles (UCLA), where she earned her M.P.H..  She is currently in the Department of Pediatrics at the University of Washington in Seattle and continues to do research in the area of antibiotic over-prescribing.

Progress to Date: This grant has been completed.  See the publications listed below for research highlights.

Highlights and Specific Accomplishments:

• Pediatric Research Consultant, Health Program, RAND.
• Professional Societies:
  • Ambulatory Pediatric Association.
  • Academy for Health Services Research and Health Policy.

K-Generated Publications:

Mangione-Smith R, Onstad K, Wong L, Roski J.  Deciding not to measure performance: The case of acute otitis media.  Joint Commission Journal on Quality and Safety 29(1):27-36.

Mangione-Smith R, Elliott MN, Stivers T, et al. Racial/ethnic variation in parent expectations for antibiotics: Implications for public health campaigns. Pediatrics 2004. 113(5)e385-e94.

Mangione-Smith R, Stivers T, Elliott M, et al. Online commentary during the physical examination: A communication tool for avoiding inappropriate antibiotic prescribing? Social Science & Medicine 2003. 56:313-20.

Stivers T, Mangione-Smith R, Elliott MN, et al. Why do physicians think parents expect antibiotics? What parents report vs what physicians believe. Journal of Family Practice 2003. (52)2:140-48.

Mangione-Smith R, Elliott MN, Stivers T. Are we sending the right message? Archives of Pediatric and Adolescent Medicine 2006. 160:945-52.

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