Dealnedergaard4704

Patient-provider communication is essential for patient-centered care, yet Asian American immigrant populations face barriers. We aim to describe 1) patient-reported communication-related characteristics for 16 disaggregated Asian American subgroups; and 2) the association of patient comprehension of provider communication with socio-demographics, language proficiency and concordance, and perceived cultural sensitivity in this population.

Descriptive statistics are presented for 1269 Asian American immigrants responding to cross-sectional, venue-sampled surveys conducted in New York City. Logistic regression models examine predictors of low comprehension of provider communication.

Approximately 11% of respondents reported low comprehension of provider communication lowest among South Asians and highest among Southeast Asians. Eighty-four percent were language-concordant with their provider, 90.1% agreed that their provider understood their background and values, and 16.5% felt their provider looked down on them. Low comprehension of provider communication was significantly associated with Southeast Asian subgroup, less education, limited English proficiency, public health insurance, patient-provider language discordance, and perceived low cultural understanding.

Among our sample, language and cultural sensitivity are associated with comprehension of provider communication.

Strategies improving language access and cultural sensitivity may be important for Asian immigrant patients. These could include interpretation services, bilingual community-based providers, and cultural sensitivity training.

Strategies improving language access and cultural sensitivity may be important for Asian immigrant patients. These could include interpretation services, bilingual community-based providers, and cultural sensitivity training.

In current objective structured clinical examinations (OSCEs), simulated encounters lacking realism reduce authenticity of assessment as students can take the OSCEs with a search-and-scan approach and trained empathy. Accordingly, patient-centeredness, the fundamental goal of OSCE, is not well assessed. This study evaluated the effect of a change in the OSCE scenario and checklist with respect to detecting students' patient-centeredness.

A scenario script for valid representation of a real clinical encounter was developed and defined as authenticated scenario. The OSCE scores and the measure of patient-centered communication (MPCC) scores of 79 medical students were compared between the two OSCE stations, one using the traditional scenario and another using the authenticated scenario.

The MPCC total score was higher in the OSCE station using the authenticated scenario than that of the traditional scenario (p < 0.001). For the OSCE scores, the patient satisfaction score and the patient-physician interaction score were higher in the station using the authenticated scenario than the traditional one (p < 0.001).

The OSCE station using the authenticated scenario better detected medical student level of patient-centeredness.

Strengthening the authenticity of the OSCE scenario is critical for detecting the medical students' levels of patient-centeredness.

Strengthening the authenticity of the OSCE scenario is critical for detecting the medical students' levels of patient-centeredness.

Low patient recruitment into diabetes prevention programs is a challenge. The primary aim of this study was to demonstrate that an increased recruitment rate can be achieved by communicating personalized risk of progression to type 2 diabetes, estimating risk reduction with weight loss, and offering program choice. Secondary aims included program participation rate, weight loss, and short-term decreased diabetes risk.

In this single-arm study, persons with prediabetes from 3 primary care sites received a letter that communicated their personalized risk of progression to diabetes within 3-years, estimated risk reduction with 5, 10, 15 % weight loss, reported in pounds, and offered a choice of 5 free, 6-month, programs. A one-sided test was used to compare the recruitment rate against the maximum expected rate of (10 %).

Recruitment response rate was 25.3 % (81/328, 95 % CI=[20.0 %, 29.4 %]) which was significantly higher than expected (p < 0.0001). Overall, 65 % of participants completed >75 % of contacts. OICR-9429 datasheet BMI, HbA1c, and diabetes risk (all p < 0.0001) improved at 6 months; BMI (p < 0.0001) and HbA1c (p < 0.05) improved at 12 months.

Recruitment response rate was better than expected.

Communicating personalized risk and reduction estimates with a choice of programs resulted in favorable outcomes, sustained at 1-year.

Communicating personalized risk and reduction estimates with a choice of programs resulted in favorable outcomes, sustained at 1-year.

To strengthen patients' health literacy and their role as active knowledge actors, we developed a health communication intervention including a film-viewing and counselling session for patients awaiting kidney transplantation. We aimed to explore processes of knowing in the translation of the intervention.

We applied an ethnographic research approach, observing nine intervention sessions with patients and dialysis nurses. Afterwards, the patients and the nurses were interviewed in-depth. Data were analysed using Engebretsen's modified version of Lonergans' four-step model of knowing.

The following knowing processes were identified i) Knowing as meaning-making; ii) Knowing as acquiring confidence; and iii) Accessing professionals' and peer experts' knowledge. Divergent considerations were taken by the different knowledge actors, which had a direct influence on the knowing processes and knowledge translation.

The findings support active interactions between patients and healthcare providers in processes of knowing. These include self-conscious approaches and critical questioning in both parties.

For transplant professionals, this study demonstrates knowing processes in a real-life context. It also spotlights professional skills and attitudes regarding the importance of self-conscious questioning and a critical interrogating position (for both patients and providers).

For transplant professionals, this study demonstrates knowing processes in a real-life context. It also spotlights professional skills and attitudes regarding the importance of self-conscious questioning and a critical interrogating position (for both patients and providers).