The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62741

Dhaval S. Patel, PhD, MPH¹, Marcia Ory, PhD², Paula Yuma, BS², and Mary Ann Cook, BSN, MA, PhD³. (1) School of Rural Health-Department of Social and Behavioral Health, Texas A & M University System-Health Science Center, 3000 Briarcrest, Suite 310, Bryan, TX 77802-1266, 979-458-8057, dspatel@srph.tamushsc.edu, (2) School of Rural Public Health, Texas A & M University, 1103 University Dr., Suite 100, College Station, TX 77840, (3) JVC Radiology and Medical Analysis LLC, 6319 Alexander Drive, Clayton, MO 63105

Although research has unearthed much about communication processes, limited scholarship uncovers how provider-older patient characteristics influence lifestyle discussions. This paper addresses three questions: (1) what percentage of visits contain nutrition, exercise, and smoking discussions based on the provider’s race and gender?, (2) what percentage of visits contain nutrition, exercise, and smoking dialogue based on the patient’s race and gender?, (3) what percentage of visits did doctors and patients who were similar in characteristics discuss lifestyle? Data from 453 videotaped visits between patients 65 and older and primary healthcare providers in the midwest and southwest were analyzed. White doctors discuss exercise and smoking more often while black physicians talk more about nutrition. Provider gender does not influence nutrition or smoking discussions, but males bring up exercise more than females. Being a white patient means talking more about exercise and smoking while black patients discuss nutrition more. Male patients mention exercise and smoking more, and females talk more often about nutrition. Black providers-black patients are likely to discuss nutrition and smoking while white providers-white patients communicate more about exercise. Female providers-male patients discuss nutrition more, and male doctors-male patients talk greater about exercise. Gender comparisons did not impact exercise communication. Three practice implications are discussed: 1) educate doctors to understand how sociodemographic characteristics influence lifestyle discussions; 2) encourage elderly patients to discuss issues that they normally do not talk about due to personal characteristics; and 3) recommend providers comprehensively discuss all three lifestyle topics since homophily is related to specific lifestyle discussions.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 1.Identify how race of the healthcare provider and elderly patient may influence communication about nutrition, exercise, and smoking.
• 2.Articulate the impact of gender of the doctor and older patient on lifestyle discussions related to nutrition, exercise, and smoking.
• 3.Discuss how racial and/or gender concordance in the physician-older patient relationship can influence talk about nutrition, exercise, and smoking.
• 4.List 3 practice-based recommendations that healthcare providers can consider for future visits with older patients.

Keywords: Elderly, Communication

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.