Provider communication quality: Influence of patients’ weight and race

Abstract

Objective To examine the relationship between patient weight and provider communication quality and determine whether patient race/ethnicity modifies this association. Methods We conducted a cross-sectional analysis with 2009-2010 Medical Expenditures Panel Survey – Household Component (N = 25,971). Our dependent variables were patient report of providers explaining well, listening, showing respect, and spending time. Our independent variables were patient weight status and patient weight-race/ethnicity groups. Using survey weights, we performed multivariate logistic regression to examine the adjusted association between patient weight and patient-provider communication measures, and whether patient race/ethnicity modifies this relationship. Results Compared to healthy weight whites, obese blacks were less likely to report that their providers explained things well (OR 0.78; p=0.02) or spent enough time with them (OR 0.81; p=0.04), and overweight blacks were also less likely to report that providers spent enough time with them (OR 0.78; p=0.02). Healthy weight Hispanics were also less likely to report adequate provider explanations (OR 0.74; p=0.04). Conclusion Our study provides preliminary evidence that overweight/obese black and healthy weight Hispanic patients experience disparities in provider communication quality. Practice Implication Curricula on weight bias and cultural competency might improve communication between providers and their overweight/obese black and healthy weight Hispanic patients.

The association between parent-reported provider communication quality and child obesity status: Variation by parent obesity and child race/ethnicity

“…Our finding that parents of obese NH Black children were more likely to report that healthcare providers always listened carefully compared to parents of non-obese NH White differs from a previous study among adults, which found that obese NH Black patients experience worse communication quality than non-obese NH Whites [30]. Taken together, these findings suggest that relationships among race, weight, and healthcare provider communication quality differ in pediatric and adult patient populations.…”

“…Our results suggest that the relationship between obesity status and healthcare provider communication quality may differ for pediatric and adults patients. Research among adults has reported that the communication and relationships of obese patients with their healthcare providers are either similar [30, 36], or worse when compared to their healthy weight counterparts [14, 15, 18, 37]. One possible explanation for this difference is that healthcare providers may be more sympathetic towards parents of obese children because they perceive a higher likelihood of successfully addressing weight issues compared to obese adult patients.…”

“…However, no study has examined whether parent obesity influences parent-healthcare provider communication. Second, research in adults has found differences in patient-healthcare provider communication quality among adults when both patient weight and race/ethnicity are considered, where obese Non-Hispanic (NH) Black patients experience worse communication quality [30]. Similarly, parents of obese minority children may also experience poor healthcare provider communication quality.…”

Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight

“…Previous studies of provider attitudes [5, 7–9], patient experiences [10, 11, 54], and access to women’s health services [12, 13, 55], suggest that body weight affects the quality of care women receive. This study provides new evidence to support those conclusions and further suggests that increased use of patient-centered communication can strengthen therapeutic relationships and enhance the quality of prenatal care for women with overweight and obesity.…”

Patient-health care professional gender or race/ethnicity concordance and its association with weight-related advice in the United States

“…Moreover, minority physicians were more likely to prescribe preventive screening tests and counseling than white physicians [27]. Obese or overweight blacks were found to be less likely to report that their providers explained things well or spent enough time with them [28]. It is not clear why patients would have higher odds of recalling being given weight-related advice from minority HCPs than from white HCPs.…”