Ethnic Disparities in Patient-Centered Communication with Healthcare Providers: A Comparison of Non-Hispanic Asians and Non-Hispanic Whites

Hao Wang; Mona Pathak; Trevor Takami; R Constance Wiener; Chan Shen; Usha Sambamoorthi

doi:10.1007/s40615-023-01898-7

Ethnic Disparities in Patient-Centered Communication with Healthcare Providers: A Comparison of Non-Hispanic Asians and Non-Hispanic Whites

J Racial Ethn Health Disparities. 2024 Jan 16. doi: 10.1007/s40615-023-01898-7. Online ahead of print.

Authors

Hao Wang¹, Mona Pathak², Trevor Takami³, R Constance Wiener⁴, Chan Shen⁵, Usha Sambamoorthi²

Affiliations

¹ Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX, 76104, USA. hwang@ies.healthcare.
² Department of Pharmacotherapy, College of Pharmacy, Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, USA.
³ Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX, 76104, USA.
⁴ Department of Dental Public Health and Professional Practice, School of Dentistry, West Virginia University, Morgantown, WV, USA.
⁵ Department of Health Services Research, Penn State College of Medicine, Hershey, PA, USA.

PMID: 38228862
DOI: 10.1007/s40615-023-01898-7

Abstract

Background: Patient-centered communication (PCC) is an important metric related to patient health outcomes. Non-Hispanic Asian (NHA) individuals reported lower PCC scores with healthcare providers than individuals of other races and ethnicities. We aim to determine the ethnic disparities in PCC and further investigate the association between PCC, individual's confidence in obtaining health-related information (health literacy), and confidence in taking care of themselves (health self-efficacy) among NHA in comparison to the Non-Hispanic White (NHW) population.

Methods: This is a cross-sectional study. We used data from the Health Information National Trends Survey 5 (HINTS) cycles 1 and 3. PCC was measured using seven validated survey questions with scores ranging from 7 to 28. Individuals' health literacy and self-efficacy were accessed using two-item survey questions. Multivariable logistic regression analyses were performed to determine the association of independent factors (e.g., self-efficacy, health literacy, and race and ethnicity) with PCC.

Results: We included 3,831 participants. Fewer NHAs (35.43%) reported high PCC scores compared to NHWs (48.99%, p = 0.0184). In fully adjusted logistic regression model, although NHAs were less likely to have high PCC scores (aOR = 0.78, 95% CI 0.46-1.32) compared to NHWs, the association was not statistically significant (p = 0.350). However, the aOR of confidence in self-efficacy associated with high PCC scores was 2.27 (95% CI 1.68-3.07, p < 0.001) and the aOR of confidence in health literacy with high PCC scores was 2.13 (95% CI 1.64-2.76, p < 0.001).

Conclusions: High PCC scores reported by NHA were not significantly different from those of NHW individuals in adjusted comparisons. Individual's confidence in self-efficacy and health literacy was positively associated with high PCC regardless of race and ethnicity.

Keywords: Health literacy; Non-Hispanic Asian; Patient-centered communication; Self-efficacy.