Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients

J Racial Ethn Health Disparities. 2019 Apr;6(2):237-244. doi: 10.1007/s40615-018-0518-6. Epub 2018 Jul 23.

Abstract

Many healthcare providers lack the awareness of health disparities among their patients that precedes action to improve outcomes. Limited health disparities training is a probable contributor. We assessed primary care residents' awareness of racial and ethnic disparities in diabetes, their perceived preparedness to discuss health disparities with patients, and their preferences for training and resources to improve their preparedness. Primary care residents (n = 98) affiliated with two teaching hospitals in North Carolina were invited to complete a 20-question health disparities survey. Fifty-two residents completed the survey (response rate = 53%). Most were non-Hispanic White (54%) and had ≤ 50% African American patients in their panel (65%). Although 83% were aware of higher diabetes prevalence among African Americans, only 31% felt prepared to discuss diabetes health disparities with patients. Their primary concerns included not having information for the discussion (58%) and being unsure how to share information in a way that is easy for patients to understand (48%). Perceived preparedness to discuss health disparities did not differ significantly by primary care resident race or percentage of African American patients in their panel. Residents indicated that having information regarding how to discuss and address health disparities would make them feel more prepared. Cultural competency training and experiential learning were the most preferred methods to learn how to identify and address health disparities. Future health disparities training should focus on improving residents' preparedness to address health disparities in their clinical practice using culturally relevant communication tools and experiential learning opportunities.

Keywords: Clinician-patient communication/relationship; Diabetes; Graduate medical education; Healthcare disparities; Instructional design.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Asian
  • Black or African American
  • Clinical Competence*
  • Communication
  • Cross-Sectional Studies
  • Cultural Competency / education
  • Diabetes Mellitus / ethnology*
  • Family Practice / education
  • Female
  • Health Status Disparities*
  • Healthcare Disparities / ethnology*
  • Humans
  • Internal Medicine / education
  • Internship and Residency
  • Male
  • Physician-Patient Relations*
  • Primary Health Care*
  • Problem-Based Learning
  • White People