Primary Care Communication Study

Principal Investigator:
Jamie Mitchell, PhD (University of Michigan School of Social Work)

Funded by:
National Institutes of Health

Project Goals & Approach:
This purpose of this study is to develop preliminary mixed-methods pilot data in support of a future behavioral intervention to improve the patient-centeredness of primary care clinical communication between physicians and older African American men, with a specific focus on understanding how older African American men actively participate as patients during clinical encounters. This study will accomplish this by identifying, analyzing and conceptually mapping verbal communicative behaviors that both facilitate and impede communication between older AAM and their physicians. Data is being utilized from an existing medical interaction research archive of video-recorded primary care visits between African American men and their physicians; as well as individual interviews with older African American men who will be recruited from the MCUAAAR participant resource pool. Existing secondary quantitative data will be utilized to triangulate findings, culminating in a mixed-methods evidence base for behavioral intervention.

Specific Aims:
Aim #1: Elicit and interpret African American male patients’ perspectives on patient-centered patient-provider communication and patient active participation including: concerns, expectations, needs, feelings, and functioning in the primary care clinical interactions. Aim #2: Identify and code verbal communicative behaviors indicative of physician’s patient-centeredness and patient’s active participation during primary care medical visits. Aim #3: Develop a conceptual framework to characterize the relationship between the primary care physician’s patient-centered communicative behaviors and the African American male patient’s active participation behaviors during the clinical encounter.

Initial Findings:
Initial findings from this study are centered around 4 main topics: African American men’s active participation in their medical encounters, the content of conversations about diabetes and pain management, the presence of companions in the doctor-patient communication dynamic, and characterizing how psychosocial and mental health concerns are addressed in primary care communication between doctors and older African American male patients.

Next steps:
Phase two of this project (June 2016-June 2017) includes gathering primary data on older African American men’s experiences with patient-centeredness and active participation in the primary care context, in the form of surveys and participant interviews. This phase includes obtaining a second IRB approval for new data collection, recruiting eligible participants from the Participant Resource Pool maintained at the Institute of Gerontology at Wayne State via MCUAAAR, collecting, cleaning, and analyzing data, and triangulating the findings from phase one’s analysis of video-recorded medical visits with men’s experiences captured in phase two.


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