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document
The effect of values affirmation on race-discordant patient-provider communication . BACKGROUND Communication between African American patients and white health care providers has been shown to be of poorer quality when compared with race-concordant patient-provider communication . Fear on the part of patients that providers stereotype them negatively might be one cause of this poorer communication . This stereotype threat may be lessened by a values-affirmation intervention . METHODS In a blinded experiment , we randomized 99 African American patients with hypertension to perform a values-affirmation exercise or a control exercise before a visit with their primary care provider . We compared patient-provider communication for the 2 groups using audio recordings of the visit analyzed with the Roter Interaction Analysis System . We also evaluated visit satisfaction , trust , stress , and mood after the visit by means of a questionnaire . RESULTS Patients in the intervention group requested and provided more information about their medical condition ( mean [ SE ] number of utterances , 66.3 [ 6.8 ] in the values-affirmation group vs 48.1 [ 5.9 ] in the control group [ P = .03 ] ) . Patient-provider communication in the intervention group was characterized as being more interested , friendly , responsive , interactive , and respectful ( P = .02 ) and less depressed and distressed ( P = .03 ) . Patient questionnaires did not detect differences in visit satisfaction , trust , stress , or mood . Mean visit duration did not differ significantly between the groups ( 19.2 minutes in the control group vs 20.5 minutes in the intervention group [ P = .29 ] ) . CONCLUSIONS A values-affirmation exercise improves aspects of patient-provider communication in race-discordant primary care visits . The clinical impact of the intervention must be defined before widespread implementation can be recommended .
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Intervention_Other
values-affirmation exercise
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Intervention_Physical
or a
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Intervention_Control
control exercise
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Intervention_Other
values-affirmation exercise
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Outcome_Other
information
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Outcome_Other
medical condition
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Outcome_Mental
interested , friendly , responsive , interactive , and respectful
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Outcome_Mental
depressed and distressed
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Outcome_Other
visit satisfaction
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Outcome_Mental
trust , stress , or mood
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Outcome_Other
Mean visit duration
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Participant_Sample-size
99
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Participant_Condition
hypertension