Skip to main content
Top
Published in: Journal of General Internal Medicine 3/2009

01-11-2009 | Original Article

The Role of Patient Activation on Patient–Provider Communication and Quality of Care for US and Foreign Born Latino Patients

Authors: Margarita Alegría, PhD, William Sribney, MS, Debra Perez, MPA, MA, PhD, Mara Laderman, BA, Kristen Keefe, BA

Published in: Journal of General Internal Medicine | Special Issue 3/2009

Login to get access

ABSTRACT

BACKGROUND

Previous research has shown positive effects of patient activation on healthcare outcomes, but there is practically no information on the generalization of these findings for Latino patients. Little data are available on whether patient activation is associated with healthcare outcomes for Latino patients and whether activation varies by language proficiency and nativity status.

OBJECTIVE

We examined the levels of activation by characteristics of Latino patients (e.g. nativity, language, health status). We investigated whether patient activation relates to the quality of care received and enhanced doctor–patient communication for Latino patients.

DESIGN

We conducted analyses of 1,067 US born and foreign born Latinos who participated in the second wave of the PEW/RWJF Hispanic Healthcare Survey during 2008.

PARTICIPANTS

Participants were self-identified Latinos (18+) with a doctor visit, living in the contiguous United States who could be contacted by telephone.

RESULTS

US born Latinos had significantly (P < 0.001) greater patient activation scores than foreign born Latinos (75 versus 70). Latinos classified as bilingual and those reporting excellent health evidenced higher mean activation scores as compared to Spanish-speaking Latinos and those reporting fair or poor health. After adjusting for demographics, health status, other language and service use factors, patient activation was strongly associated with self-reported quality of care and better doctor–patient communication among both US and foreign born Latino respondents.

CONCLUSIONS

Interventions that augment patient activation could increase quality of care and improved patient–provider communication, potentially reducing health care disparities for Latinos.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hibbard J, Cunningham P. How Engaged are Consumers in Their Health and Health Care, and Why Does It Matter? Washington: Center for Studying Health System Change; 2008. Hibbard J, Cunningham P. How Engaged are Consumers in Their Health and Health Care, and Why Does It Matter? Washington: Center for Studying Health System Change; 2008.
2.
go back to reference Clayton J, Butow P, Tattersall M, et al. Asking questions can help: Development and preliminary evaluation of a question prompt list for palliative care patients. Br J Cancer. 2003; 8911: 2069–77.CrossRefPubMed Clayton J, Butow P, Tattersall M, et al. Asking questions can help: Development and preliminary evaluation of a question prompt list for palliative care patients. Br J Cancer. 2003; 8911: 2069–77.CrossRefPubMed
3.
go back to reference Miranda J, Cooper L. Disparities in care for depression among primary care patients. J Gen Intern Med. 2004; 192: 120–6.CrossRefPubMed Miranda J, Cooper L. Disparities in care for depression among primary care patients. J Gen Intern Med. 2004; 192: 120–6.CrossRefPubMed
4.
go back to reference Clever SL, Ford DE, Rubenstein LV, et al. Primary care patients’ involvement in decision-making is associated with improvement in depression. Med Care. 2006; 445: 398–405.CrossRefPubMed Clever SL, Ford DE, Rubenstein LV, et al. Primary care patients’ involvement in decision-making is associated with improvement in depression. Med Care. 2006; 445: 398–405.CrossRefPubMed
5.
go back to reference Post DM, Cegala DJ, Miser WF. The other half of the whole: teaching patients to communicate with physicians. Fam Med. 2002; 345: 344–52.PubMed Post DM, Cegala DJ, Miser WF. The other half of the whole: teaching patients to communicate with physicians. Fam Med. 2002; 345: 344–52.PubMed
6.
go back to reference Korsch BM, Gozzi EK, Francis V. Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. Pediatrics. 1968; 425: 855–71.PubMed Korsch BM, Gozzi EK, Francis V. Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. Pediatrics. 1968; 425: 855–71.PubMed
7.
go back to reference Roter D, Stewart M, Putnam S, Lipkin MJ, Stiles W, Inui T. Communication patterns of primary care physicians. JAMA. 1997; 277: 350–6.CrossRefPubMed Roter D, Stewart M, Putnam S, Lipkin MJ, Stiles W, Inui T. Communication patterns of primary care physicians. JAMA. 1997; 277: 350–6.CrossRefPubMed
8.
go back to reference Beisdecker AE, Beisdecker TD. Patient information-seeking behaviors when communicating with doctors. Med Care. 1990; 28: 19–28.CrossRef Beisdecker AE, Beisdecker TD. Patient information-seeking behaviors when communicating with doctors. Med Care. 1990; 28: 19–28.CrossRef
10.
go back to reference Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988; 26: 657–75.CrossRefPubMed Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior in medical encounters. Med Care. 1988; 26: 657–75.CrossRefPubMed
11.
go back to reference Stewart AL, Sherbourne CD, Wells KB, et al. Do depressed patients in different treatment settings have different levels of well-being and functioning? J Consult Clin Psychol. 1993; 615: 849–57.CrossRefPubMed Stewart AL, Sherbourne CD, Wells KB, et al. Do depressed patients in different treatment settings have different levels of well-being and functioning? J Consult Clin Psychol. 1993; 615: 849–57.CrossRefPubMed
12.
go back to reference Blanchard CG, Labrecque MS, Ruckdeschel JC, Blanchard EB. Physician behaviors, patient perceptions, and patient characteristics as predictors of satisfaction of hospitalized adult cancer patients. Cancer. 1990; 651: 186–92.CrossRefPubMed Blanchard CG, Labrecque MS, Ruckdeschel JC, Blanchard EB. Physician behaviors, patient perceptions, and patient characteristics as predictors of satisfaction of hospitalized adult cancer patients. Cancer. 1990; 651: 186–92.CrossRefPubMed
13.
go back to reference Rosenberg EE, Lussier MT, Beaudoin C. Lessons for clinicians from physician-patient communication literature. Arch Fam Med. 1997; 63: 279–83.CrossRefPubMed Rosenberg EE, Lussier MT, Beaudoin C. Lessons for clinicians from physician-patient communication literature. Arch Fam Med. 1997; 63: 279–83.CrossRefPubMed
14.
go back to reference Epstein R, Campbell T, Cohen-Cole S, McWhinney I, Smilkstein G. Perspectives on patient-doctor communication. J Fam Pract. 1993; 37: 377–88.PubMed Epstein R, Campbell T, Cohen-Cole S, McWhinney I, Smilkstein G. Perspectives on patient-doctor communication. J Fam Pract. 1993; 37: 377–88.PubMed
15.
go back to reference Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989; 273 Supp: S110–127.CrossRefPubMed Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989; 273 Supp: S110–127.CrossRefPubMed
16.
go back to reference Brown B, Butow P, Dunn SM, Tattersall M. Promoting patient participation and shortening cancer consultations: a randomized trial. Br J Cancer. 2001; 859: 1273–9.CrossRefPubMed Brown B, Butow P, Dunn SM, Tattersall M. Promoting patient participation and shortening cancer consultations: a randomized trial. Br J Cancer. 2001; 859: 1273–9.CrossRefPubMed
17.
go back to reference Pibernik-Okanovic M, Prasek M, Poljicanin-Filipovic T, Pavlic-Renar I, Metelko Z. Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients. Patient Educ Couns. 2004; 52: 193–9.CrossRefPubMed Pibernik-Okanovic M, Prasek M, Poljicanin-Filipovic T, Pavlic-Renar I, Metelko Z. Effects of an empowerment-based psychosocial intervention on quality of life and metabolic control in type 2 diabetic patients. Patient Educ Couns. 2004; 52: 193–9.CrossRefPubMed
18.
go back to reference Roter DL. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Educ Monogr. 1977; 54: 281–315.PubMed Roter DL. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Educ Monogr. 1977; 54: 281–315.PubMed
19.
go back to reference Thompson SC, Nanni C, Schwankovsky L. Patient-oriented interventions to improve communication in a medical office visit. Health Psychol. 1990; 94: 390–404.CrossRefPubMed Thompson SC, Nanni C, Schwankovsky L. Patient-oriented interventions to improve communication in a medical office visit. Health Psychol. 1990; 94: 390–404.CrossRefPubMed
20.
go back to reference Tsay S, Hung L. Empowerment of patients with end-stage renal disease–a randomized controlled trial. Int J Nurs Stud. 2004; 411: 59–65.CrossRefPubMed Tsay S, Hung L. Empowerment of patients with end-stage renal disease–a randomized controlled trial. Int J Nurs Stud. 2004; 411: 59–65.CrossRefPubMed
21.
go back to reference Eisenthal S, Lazare A. Evaluation of the initial interview in a walk-in clinic. The patient’s perspective on a "customer approach". J Nerv Ment Dis. 1976; 1623: 169–76.PubMedCrossRef Eisenthal S, Lazare A. Evaluation of the initial interview in a walk-in clinic. The patient’s perspective on a "customer approach". J Nerv Ment Dis. 1976; 1623: 169–76.PubMedCrossRef
22.
go back to reference Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. J Pediatr. 2000; 1361: 14–23.CrossRefPubMed Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. J Pediatr. 2000; 1361: 14–23.CrossRefPubMed
23.
go back to reference American Medical Association. Culturally Competent Healthcare for Adolescents: a Guide for Primary Care Proiders. Chicago: American Medical Association; 1994. American Medical Association. Culturally Competent Healthcare for Adolescents: a Guide for Primary Care Proiders. Chicago: American Medical Association; 1994.
24.
go back to reference Levinson W, Kao A, Kuby A, Thisted R. Not all patients want to participate in decision making. J Gen Intern Med. 2005; 206: 531–5.CrossRefPubMed Levinson W, Kao A, Kuby A, Thisted R. Not all patients want to participate in decision making. J Gen Intern Med. 2005; 206: 531–5.CrossRefPubMed
25.
go back to reference Xu K, Borders T, Arif A. Ethnic differences in parents’ perception of participatory decision-making style of their children’s physicians. Med Care. 2004; 424: 328–35.CrossRefPubMed Xu K, Borders T, Arif A. Ethnic differences in parents’ perception of participatory decision-making style of their children’s physicians. Med Care. 2004; 424: 328–35.CrossRefPubMed
26.
go back to reference Hibbard J, Stockard J, Mahoney E, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004; 394p1: 1005–26.CrossRefPubMed Hibbard J, Stockard J, Mahoney E, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004; 394p1: 1005–26.CrossRefPubMed
27.
go back to reference Cortés D, Mulvaney-Day N, Fortuna L, Reinfeld S, Alegría M. Patient–provider communication: understanding the role of patient activation for Latinos in mental health treatment. Health Educ Behav. 2008;EPub. Cortés D, Mulvaney-Day N, Fortuna L, Reinfeld S, Alegría M. Patient–provider communication: understanding the role of patient activation for Latinos in mental health treatment. Health Educ Behav. 2008;EPub.
28.
go back to reference Current Population Survey. Annual Social and Economic (ASEC) Supplement, Conducted by the Bureau of the Census for the Bureau of Labor Statistics. Washington: U.S. Census Bureau; 2007. Current Population Survey. Annual Social and Economic (ASEC) Supplement, Conducted by the Bureau of the Census for the Bureau of Labor Statistics. Washington: U.S. Census Bureau; 2007.
29.
go back to reference Livingston G, Minushkin S, Cohn D. Hispanics and Health Care in the United States: Access, Information and Knowledge: PEW Hispanic Center and Robert Wood Johnson Foundation; 2008. Livingston G, Minushkin S, Cohn D. Hispanics and Health Care in the United States: Access, Information and Knowledge: PEW Hispanic Center and Robert Wood Johnson Foundation; 2008.
30.
go back to reference Stewart A, Nápoles-Springer A, Gregorich S, Santoyo-Olsson J. Interpersonal processes of care survey: patient-reported measures for diverse groups. Health Serv Res. 2007; 423p1: 1235–56.CrossRefPubMed Stewart A, Nápoles-Springer A, Gregorich S, Santoyo-Olsson J. Interpersonal processes of care survey: patient-reported measures for diverse groups. Health Serv Res. 2007; 423p1: 1235–56.CrossRefPubMed
31.
go back to reference Stata Statistical Software Version 10.1. [computer program]. Version. College Station, TX; 2008. Stata Statistical Software Version 10.1. [computer program]. Version. College Station, TX; 2008.
32.
go back to reference Alegría M, Polo A, Gao S, et al. Evaluation of a patient activation and empowerment intervention in mental health care. Med Care. 2008; 463: 247.CrossRefPubMed Alegría M, Polo A, Gao S, et al. Evaluation of a patient activation and empowerment intervention in mental health care. Med Care. 2008; 463: 247.CrossRefPubMed
33.
go back to reference Schaafsma ES, Raynor TD, de Jong-van den Berg LT. Accessing medication information by ethnic minorities: barriers and possible solutions. Pharm World Sci. 2003; 255: 185–90.CrossRefPubMed Schaafsma ES, Raynor TD, de Jong-van den Berg LT. Accessing medication information by ethnic minorities: barriers and possible solutions. Pharm World Sci. 2003; 255: 185–90.CrossRefPubMed
34.
go back to reference Charles C, Whelan T, Gafni A, Willan A, Farrell S. Shared treatment decision making: what does it mean to physicians? J General Clinical Oncology. 2003; 21: 932–6.CrossRef Charles C, Whelan T, Gafni A, Willan A, Farrell S. Shared treatment decision making: what does it mean to physicians? J General Clinical Oncology. 2003; 21: 932–6.CrossRef
Metadata
Title
The Role of Patient Activation on Patient–Provider Communication and Quality of Care for US and Foreign Born Latino Patients
Authors
Margarita Alegría, PhD
William Sribney, MS
Debra Perez, MPA, MA, PhD
Mara Laderman, BA
Kristen Keefe, BA
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue Special Issue 3/2009
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1074-x

Other articles of this Special Issue 3/2009

Journal of General Internal Medicine 3/2009 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.