April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Creating Equity Through Micro-Interactional Analysis of Complementary and Integrative Health Communication
Background: The World Health Organization (WHO) affirms health is a fundamental human right that is most equitable when the unfair, avoidable, or remediable differences in health outcomes are addressed to contribute to everyone’s overall health and well-being. Communication is central to pursuing this goal, and dyadic relationships between clinicians and patients are a fundamental site to explore how communication can facilitate intermediate and distal health outcomes. One specific remediable area in dyadic healthcare interactions is in clinician patient discussion of Complementary and Integrative Health (CIH).
Methods: We will complete a secondary analysis of previously collected recorded interactions of CIH talk in biomedical visits. These examples were chosen because they were instances showing the interactional consequences of small moments of minimal response versus engagement. We will reexamine these data using discourse analysis with an eye toward issues of health (in)equity.
Results: Two specific micro examples of communicative inequity will be presented and our analysis suggests a pathway that can contribute to increasing proximal and intermediate health outcomes of CIH talk, including understanding, feeling known, trust, and commitment to recommended treatment. These examples of healthcare interaction shows how responding to patients’ mentions of CIH can promote a more contextual view of what patients value in their healthcare to reduce avoidable differences in proximal and intermediate health outcomes promote equity and health justice.
Discussion: Previous research has shown that clinicians differentially respond to people who initiate talk about CIH modalities. For example, Koenig et al (2015) showed that 45% of patient-initiated CIH mentions were either disattended, that is, communicatively ignored, or merely acknowledged, that is, garnered a minimal response, by clinicians in oncology visits. This same disattention occurs in Chinese language visits as well (Ho, et al., 2022). While not universally negative, when compounded with other health inequities or a history of distrust, disattention to CIH talk, especially ignoring a patient’s disclosure or question may be easily avoidable. We present this problem as an equity priority because talking about CIH is a remediable communication practice. The quality of communication of biomedical encounters can be improved through the model of lifeworld talk that integrates a patients’ health concerns, priorities, and practices in ways that make sense for both patients and clinicians.
Methods: We will complete a secondary analysis of previously collected recorded interactions of CIH talk in biomedical visits. These examples were chosen because they were instances showing the interactional consequences of small moments of minimal response versus engagement. We will reexamine these data using discourse analysis with an eye toward issues of health (in)equity.
Results: Two specific micro examples of communicative inequity will be presented and our analysis suggests a pathway that can contribute to increasing proximal and intermediate health outcomes of CIH talk, including understanding, feeling known, trust, and commitment to recommended treatment. These examples of healthcare interaction shows how responding to patients’ mentions of CIH can promote a more contextual view of what patients value in their healthcare to reduce avoidable differences in proximal and intermediate health outcomes promote equity and health justice.
Discussion: Previous research has shown that clinicians differentially respond to people who initiate talk about CIH modalities. For example, Koenig et al (2015) showed that 45% of patient-initiated CIH mentions were either disattended, that is, communicatively ignored, or merely acknowledged, that is, garnered a minimal response, by clinicians in oncology visits. This same disattention occurs in Chinese language visits as well (Ho, et al., 2022). While not universally negative, when compounded with other health inequities or a history of distrust, disattention to CIH talk, especially ignoring a patient’s disclosure or question may be easily avoidable. We present this problem as an equity priority because talking about CIH is a remediable communication practice. The quality of communication of biomedical encounters can be improved through the model of lifeworld talk that integrates a patients’ health concerns, priorities, and practices in ways that make sense for both patients and clinicians.