217858 Test of a patient-centered culturally sensitive health care model for understanding treatment adherence among a national sample of hispanic patients

Wednesday, November 10, 2010

Jessica Jones, MS , Department of Psychology, University of Florida, Gainesville, FL
Carolyn M. Tucker, PhD , Department of Psychology, University of Florida, Gainesville, FL
Due to the growing numbers of Hispanics living in the U.S., increasing numbers of these individuals will be negatively impacted by health disparities. The purpose of this study tested the impact of components of a model that explains general treatment adherence. Specifically, the objective of the present study was to determine whether the processes through which patient-perceived cultural sensitivity, trust in physician, satisfaction with physician care, and patient control in the treatment decision-making process affect general treatment adherence similarly or differently in primarily English-speaking and primarily Spanish-speaking Hispanic patients. Data from 194 primarily English-speaking and 361 primarily Spanish-speaking Hispanic patients were utilized and analyzed to test the effects of the constructs using multi-group structural equation modeling. No significant direct effects of provider culturally sensitive behaviors and attitudes on general treatment adherence were found, however several significant indirect effects emerged. Language appeared to have moderating effects on the relationships between patient-perceived provider cultural sensitivity and general treatment adherence. Specifically, patient-perceived provider cultural sensitivity, trust in physician, and satisfaction with physician care have effects on general treatment adherence in English-speaking and Spanish-speaking Hispanic patients, but the processes and mechanisms through which they exert their effects differed among the groups. The differences may be related to language barriers as well as socioeconomic disadvantages disproportionately experienced by Spanish-speaking Hispanics living in the U.S. It was also found that both male and female English-speaking Hispanics had significantly higher general treatment adherence scores than their Spanish-speaking counterparts. These results suggest that interventions to address limited English proficiency may be important in improving the quality of primary care for this rapidly growing population.

Learning Areas:
Assessment of individual and community needs for health education
Communication and informatics
Diversity and culture

Learning Objectives:
1. Explain the unique cultural and language factors that influence treatment adherence practices among Hispanics who are at risk for severe chronic health conditions; 2. Describe the influence of language, patient-centered culturally sensitive health care, trust, satisfaction, control in the treatment decision-making process, and treatment adherence simultaneously among a national sample of Hispanics living in the U.S.; 3. Compare the levels of treatment adherence and related variables between primarily Spanish-speaking Hispanics and primarily English-speaking Hispanics; and 4. Identify provider-patient relationship related variables (i.e., trust in physician, satisfaction with physician care, and patient control in the treatment decision-making process) that influence treatment adherence among these two linguistic groups using a modified version of the Patient-Centered Culturally Sensitive Health Care Model

Keywords: Access and Services, Cultural Competency

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I served as the director on the Behavioral Medicine Team, analyzed the data, interpreted the results, and wrote the abstract as well as the related paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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