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; Cohn, Jonathon; Wilson, Ira B.; Eggly, Susan; Cooper, Lisa A.; Roter, Debra; Sankar, Andrea; Moore, Richard; Wilson, Ira
July 2010
JGIM: Journal of General Internal Medicine;Jul2010, Vol. 25 Issue 7, p682
Academic Journal
journal article
Background: Hispanic Americans with HIV/AIDS experience lower quality care and worse outcomes than non-Hispanic whites. While deficits in patient-provider communication may contribute to these disparities, no studies to date have used audio recordings to examine the communication patterns of Hispanic vs. non-Hispanic white patients with their health care providers.Objective: To explore differences in patient-provider communication for English-speaking, HIV-infected Hispanic and non-Hispanic white patients.Design: Cross-sectional analysis.Setting: Two HIV care sites in the United States (New York and Portland) participating in the Enhancing Communication and HIV Outcomes (ECHO) study.Subjects: Nineteen HIV providers and 113 of their patients.Measurements: Patient interviews, provider questionnaires, and audio-recorded, routine, patient-provider encounters coded with the Roter Interaction Analysis System (RIAS).Results: Providers were mostly non-Hispanic white (68%) and female (63%). Patients were Hispanic (51%), and non-Hispanic white (49%); 20% were female. Visits with Hispanic patients were less patient-centered (0.75 vs. 0.90, p = 0.009), with less psychosocial talk (80 vs. 118 statements, p < 0.001). This pattern was consistent among Hispanics who spoke English very well and those with less English proficiency. There was no association between patient race/ethnicity and visit length, patients' or providers' emotional tone, or the total number of patient or provider statements categorized as socioemotional, question-asking, information-giving, or patient activating. Hispanic patients gave higher ratings than whites (AOR 3.05 Hispanic vs. white highest rating of providers' interpersonal style, 95% CI 1.20-7.74).Conclusion: In this exploratory study, we found less psychosocial talk in patient-provider encounters with Hispanic compared to white patients. The fact that Hispanic patients rated their visits more positively than whites raises the possibility that these differences in patient-provider interactions may reflect differences in patient preferences and communication style rather than "deficits" in communication. If these findings are replicated in future studies, efforts should be undertaken to understand the reasons underlying them and their impact on the quality and equity of care.


Related Articles

  • Decision-making role preferences among patients with HIV: associations with patient and provider characteristics and communication behaviors. Kumar, Rashmi; Korthuis, P. Todd; Saha, Somnath; Chander, Geetanjali; Sharp, Victoria; Cohn, Jonathon; Moore, Richard; Beach, Mary Catherine // JGIM: Journal of General Internal Medicine;Jun2010, Vol. 25 Issue 6, p517 

    Background: A preference for shared decision-making among patients with HIV has been associated with better health outcomes. One possible explanation for this association is that patients who prefer a more active role in decision-making are more engaged in the communication process...

  • Impact of patient race on patient experiences of access and communication in HIV care. Korthuis, P. Todd; Saha, Somnath; Fleishman, John A.; McGrath, Moriah McSharry; Josephs, Joshua S.; Moore, Richard D.; Gebo, Kelly A.; Hellinger, James; Beach, Mary Catherine; HIV Research Network // JGIM: Journal of General Internal Medicine;Dec2008, Vol. 23 Issue 12, p2046 

    Background: Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes.Objective: To explore associations between race and HIV-infected patients' experiences of access and...

  • Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV? Beach, Mary Catherine; Keruly, Jeanne; Moore, Richard D. // JGIM: Journal of General Internal Medicine;Jun2006, Vol. 21 Issue 6, p661 

    PURPOSE: Patient-centeredness, originally defined as understanding each patient as a unique person, is widely considered the standard for high-quality interpersonal care. The purpose of our study was to examine the association between patient perception of being ‘known as a person’...

  • Recruiting ethnically diverse general internal medicine patients for a telephone survey on physician-patient communication. Nápoles-Springer, Anna M.; Santoyo, Jasmine; Stewart, Anita L.; Nápoles-Springer, Anna M // JGIM: Journal of General Internal Medicine;May2005, Vol. 20 Issue 5, p438 

    Background: Limited evidence exists on the effectiveness of recruitment methods among diverse populations.Objective: Describe response rates by recruitment stage, ethnic-language group, and type of initial contact letter (for African-American and Latino...

  • Patterns of interpreter use for hospitalized patients with limited English proficiency. Schenker, Yael; Pérez-Stable, Eliseo; Nickleach, Dana; Karliner, Leah; Pérez-Stable, Eliseo J; Karliner, Leah S // JGIM: Journal of General Internal Medicine;Jul2011, Vol. 26 Issue 7, p712 

    Background: Professional interpreter use improves the quality of care for patients with limited English proficiency (LEP), but little is known about interpreter use in the hospital.Objective: Evaluate interpreter use for clinical encounters in the hospital.Design:...

  • Are health-care relationships important for mammography adherence in Latinas? Sheppard, Vanessa B.; Wang, Judy; Bin Yi; Harrison, Toni Michelle; Shibao Feng; Huerta, Elmer E.; Mandelblatt, Jeanne S.; Yi, Bin; Feng, Shibao; Latin American Cancer Research Coalition // JGIM: Journal of General Internal Medicine;Dec2008, Vol. 23 Issue 12, p2024 

    Background: Latinas are the fastest growing racial ethnic group in the United States and have an incidence of breast cancer that is rising three times faster than that of non-Latino white women, yet their mammography use is lower than that of non-Latino women.Objectives:...

  • Nature and correlates of SF-12 physical and mental quality of life components among low-income HIV adults using an HIV service center. Viswanathan, Hema; Anderson, Rodney; Thomas, III, Joseph; Thomas, Joseph 3rd // Quality of Life Research;May2005, Vol. 14 Issue 4, p935 

    Objectives: This study describes health-related quality of life (HRQOL) among low-income HIV adults using an HIV service center, compares participants' scores to US published norms for the general population and persons with chronic conditions, and examines relationships between...

  • "We'll do this together": the role of the first person plural in fostering partnership in patient-physician relationships. Kinsman, Helen; Roter, Debra; Berkenblit, Gail; Saha, Somnath; Korthuis, P. Todd; Wilson, Ira; Eggly, Susan; Sankar, Andrea; Sharp, Victoria; Cohn, Jonathon; Moore, Richard D.; Beach, Mary Catherine // JGIM: Journal of General Internal Medicine;Mar2010, Vol. 25 Issue 3, p186 

    Partnership is integral to therapeutic relationships, yet few studies have examined partnership-fostering communication behaviors in the clinic setting. We conducted this study to better understand how statements in which physicians use the first person plural might foster partnership between...

  • Time to depression treatment in primary care among HIV-infected and uninfected veterans. Hooshyar, Dina; Goulet, Joseph; Chwastiak, Lydia; Crystal, Steven; Gibert, Cynthia; Mattocks, Kristin; Rimland, David; Rodriguez-Barradas, Maria; Justice, Amy C.; VACS Project Team // JGIM: Journal of General Internal Medicine;Jul2010, Vol. 25 Issue 7, p656 

    Background: Multiple factors, including patient characteristics, competing demands, and clinic type, impact delivery of depression treatment in primary care.Objective: Assess whether depression severity and HIV serostatus have a differential effect on time to depression...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics