Differences in Patient–Provider Communication for Hispanic Compared to Non-Hispanic White Patients in HIV Care

Beach, Mary Catherine; Saha, Somnath; Korthuis, P. Todd; Sharp, Victoria L.; Cohn, Jonathon; Wilson, Ira B.; Eggly, Susan; Cooper, Lisa A.; Roter, Debra; Sankar, Andrea; Moore, Richard D.

doi:10.1007/s11606-010-1310-4

Cited by 81 publications

(76 citation statements)

References 19 publications

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“…14,15 Study participants were patients infected with the human immunodeficiency virus (HIV) and their clinicians at 4 HIV care sites in the United States (Baltimore, Detroit, New York, and Portland). The study received institutional review board approval from each of the 4 sites; both patients and clinicians gave written informed consent.…”

Section: Methodsmentioning

confidence: 99%

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A Multicenter Study of Physician Mindfulness and Health Care Quality

Beach

Roter

Korthuis

et al. 2013

The Annals of Family Medicine

189

129

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PURPOSE Mindfulness (ie, purposeful and nonjudgmental attentiveness to one's own experience, thoughts, and feelings) is associated with physician well-being. We sought to assess whether clinician self-rated mindfulness is associated with the quality of patient care. METHODSWe conducted an observational study of 45 clinicians (34 physicians, 8 nurse practitioners, and 3 physician assistants) caring for patients infected with the human immunodeficiency virus (HIV) who completed the Mindful Attention Awareness Scale and 437 HIV-infected patients at 4 HIV specialty clinic sites across the United States. We measured patient-clinician communication quality with audio-recorded encounters coded using the Roter Interaction Analysis System (RIAS) and patient ratings of care. RESULTSIn adjusted analyses comparing clinicians with highest and lowest tertile mindfulness scores, patient visits with high-mindfulness clinicians were more likely to be characterized by a patient-centered pattern of communication (adjusted odds ratio of a patient-centered visit was 4.14; 95% CI, 1.58-10.86), in which both patients and clinicians engaged in more rapport building and discussion of psychosocial issues. Clinicians with high-mindfulness scores also displayed more positive emotional tone with patients (adjusted β = 1.17; 95% CI, 0.46-1.9). Patients were more likely to give high ratings on clinician communication (adjusted prevalence ratio [APR] = 1.48; 95% CI, 1.17-1.86) and to report high overall satisfaction (APR = 1.45; 95 CI, 1.15-1.84) with high-mindfulness clinicians. There was no association between clinician mindfulness and the amount of conversation about biomedical issues.CONCLUSIONS Clinicians rating themselves as more mindful engage in more patient-centered communication and have more satisfied patients. Interventions should determine whether improving clinician mindfulness can also improve patient health outcomes.

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Section: Methodsmentioning

confidence: 99%

“…14,15,[25][26][27][28] A value greater than 1 denotes a more patient-centered and a value less than 1 a more doctor-centered encounter.…”

Section: Audio-recorded Measures Of Patient and Clinician Communicationmentioning

confidence: 99%

A Multicenter Study of Physician Mindfulness and Health Care Quality

Beach

Roter

Korthuis

et al. 2013

The Annals of Family Medicine

189

129

View full text Add to dashboard Cite

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“…The design of the ECHO study has been previously published. [23][24][25][26] Briefly, study subjects were HIV pro- …”

Section: Methodsmentioning

confidence: 99%

Internet Health Information Seeking Behavior and Antiretroviral Adherence in Persons Living with HIV/AIDS

Samal

Saha

Chander

et al. 2011

AIDS Patient Care and STDs

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While the Internet has the potential to educate persons living with HIV/AIDS (PLWHA), websites may contain inaccurate information and increase the risk of nonadherence with antiretroviral therapy (ART). The objectives of our study were to determine the extent to which PLWHA engage in Internet health information seeking behavior (IHISB) and to determine whether IHISB is associated with ART adherence. We conducted a survey of adult, English-speaking HIV-infected patients at four HIV outpatient clinic sites in the United States (Baltimore, Maryland; Detroit, Michigan; New York, and Portland, Oregon) between December 2004 and January 2006. We assessed IHISB by asking participants how much information they had received from the Internet since acquiring HIV. The main outcome was patient-reported ART adherence over the past three days. Data were available on IHISB for 433 patients, 334 of whom were on ART therapy. Patients had a mean age of 45 (standard error [SE] 0.45) years and were mostly male (66%), African American (58%), and had attained a high school degree (73%). Most (55%) reported no IHISB, 18% reported some, and 27% reported ''a fair amount'' or ''a great deal.'' Patients who reported higher versus lower levels of IHISB were significantly younger, had achieved a higher level of education, and had higher medication self-efficacy. In unadjusted analyses, higher IHISB was associated with ART adherence (odds ratio [OR], 2.96, 95% confidence interval [CI] 1.27-6.94). This association persisted after adjustment for age, gender, race, education, clinic site, and medication self-efficacy (adjusted odds ratio [AOR] 2.76, 95% CI 1.11-6.87). Our findings indicate that IHISB is positively associated with ART adherence even after controlling for potentially confounding variables. Future studies should investigate the ways in which Internet health information may promote medication adherence among PLWHA.

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“…[31][32][33] Subjects were PCPs and their patients at four outpatient HIV care sites (Baltimore, Detroit, New York, and Portland, OR) participating in the HIV Research Network. 34 The study received Institutional Review Board approval from each site.…”

Section: Study Sample and Settingmentioning

confidence: 99%

Primary Care Provider Cultural Competence and Racial Disparities in HIV Care and Outcomes

et al. 2013

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BACKGROUND: Health professional organizations have advocated for increasing the "cultural competence" (CC) of healthcare providers, to reduce racial and ethnic disparities in patient care. It is unclear whether provider CC is associated with more equitable care. OBJECTIVE: To evaluate whether provider CC is associated with quality of care and outcomes for patients with HIV/AIDS. DESIGN AND PARTICIPANTS: Survey of 45 providers and 437 patients at four urban HIV clinics in the U.S. MAIN MEASURES: Providers' self-rated CC was measured using a novel, 20-item instrument. Outcome measures included patients' receipt of antiretroviral (ARV) therapy, self-efficacy in managing medication regimens, complete 3-day ARV adherence, and viral suppression. KEY RESULTS: Providers' mean age was 44 years; 56 % were women, and 64 % were white. Patients' mean age was 45; 67 % were men, and 77 % were nonwhite. Minority patients whose providers scored in the middle or highest third on self-rated CC were more likely than those with providers in the lowest third to be on ARVs, have high self-efficacy, and report complete ARV adherence. Racial disparities were observed in receipt of ARVs (adjusted OR, 95 % CI for white vs. nonwhite: 6.21, 1.50-25.7), self-efficacy (3.77, 1.24-11.4), and viral suppression (13.0, 3.43-49.0) among patients of low CC providers, but not among patients of moderate and high CC providers (receipt of ARVs: 0.71, 0.32-1.61; self-efficacy: 1.14, 0.59-2.22; viral suppression: 1.20, 0.60-2.42). CONCLUSIONS: Provider CC was associated with the quality and equity of HIV care. These findings suggest that enhancing provider CC may reduce racial disparities in healthcare quality and outcomes.

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Differences in Patient–Provider Communication for Hispanic Compared to Non-Hispanic White Patients in HIV Care

Cited by 81 publications

References 19 publications

A Multicenter Study of Physician Mindfulness and Health Care Quality

A Multicenter Study of Physician Mindfulness and Health Care Quality

Internet Health Information Seeking Behavior and Antiretroviral Adherence in Persons Living with HIV/AIDS

Primary Care Provider Cultural Competence and Racial Disparities in HIV Care and Outcomes

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