April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Individual Differences in the Mediating Role of Patient-centered Communication in Cancer Patient Health Outcomes
Introduction: Patient-centered communication (PCC) is a health care approach that encourages patients to play an active role in the decision making regarding the health needs (Epstein et al., 2005). Greater PCC is associated with greater general health status (Stewart et al., 2000) and higher quality patient care (Epstein et al., 2005). While studies have analyzed the individual characteristics that influence PCC (Finney Rutten et al., 2015; Spooner et al., 2016), the results are largely inconsistent. Further, research on these factors contingent on a cancer diagnosis is virtually nonexistent. Drawing from Epstein et al.’s (2005) framework of PCC, we investigate the mediating role of PCC between patient factors, such as race/ethnicity and socioeconomic status, and relationship factors, such as provider trust and provider visit frequency, on two health outcomes, general health status and perceived quality of care (see Figure 1). All corresponding figures and tables are available at the following link: https://osf.io/93wfe/?view_only=9b6c347e3c894d899dc99f2722722a51. Method: To explore these relationships, data from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4; HINTS, 2020) were used. The final eligible sample included 576 participants. Participant demographics are located in Table 1. All participants had a history of cancer and visited a health care provider within the last 12 months. Results: Correlations between all variables are available in Table 2. Age, identifying as a racial minority (compared to White/Caucasian), and provider trust were positively associated with PCC, whereas identifying as Hispanic or Latino/a/x (compared to non-Hispanic or Latino/a/x) was negatively associated with PCC (see Table 3). To investigate the mediating role of PCC, we used Hayes’s (2017) PROCESS model 4. PCC significantly mediated the relationship between identifying as Hispanic or Latino/a/x (compared to non-Hispanic or Latino/a/x), identifying as a racial minority (compared to White/Caucasian) and provider trust and the outcome variables, health status and quality of care (see Table 4). Discussion: This study highlights the mediating role of PCC among cancer patients. First, provider trust and identifying as a racial minority (compared to White/Caucasian) cancer patient are critical for fostering greater experiences of PCC. Yet, Hispanic or Latino/a/x cancer patients reported lower levels of PCC compared to non-Hispanic or Latino/a/x individuals. Though these findings conflict with previous research (Johnson et al., 2004), previous researchers did not focus on cancer patients. Thus, unique processes related to cancer patients are at play. Second, PCC explains why provider trust, identifying as a racial minority, and identifying as non-Hispanic or Latino/a/x has an effect on health outcomes. Thus, it is likely that English proficiency and cultural differences are barriers to PCC among Hispanic and Latino/a/x patients (Chu et al., 2019). Future work should explore this divergence between racial/ethnic minority groups to investigate why certain demographics report greater PCC than others and why the benefits of communication differ amongst groups. We expand on the implications of these varied relationships in our full paper.