Provider Communication Research Articles

Impact of Telemedicine Adoption on Patient Satisfaction during Post-Pandemic Healthcare Delivery in Ethiopia

Purpose: The aim of the study was to investigate the impact of telemedicine adoption on patient satisfaction during post-pandemic healthcare delivery. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Telemedicine has improved patient satisfaction by increasing accessibility, reducing travel and wait times, and offering flexible appointments. Patients appreciated the convenience, but challenges like digital literacy gaps, limited internet access, and data privacy concerns affected satisfaction for some. Personalized provider communication significantly boosted positive experiences. Disparities in satisfaction were observed, with older adults and low-income groups facing more barriers. Unique Contribution to Theory, Practice and Policy: Technology acceptance model (TAM), diffusion of innovations theory & expectation-confirmation theory (ECT) may be used to anchor future studies on the impact of telemedicine adoption on patient satisfaction during post-pandemic healthcare delivery. Telemedicine platforms should be developed with a user-centric approach, emphasizing simplicity, accessibility, and adaptability to meet the needs of diverse patient populations, including older adults and those with limited digital skills. Policymakers should also introduce incentives such as subsidies for technology upgrades and reimbursement parity between telemedicine and in-person visits to encourage widespread adoption.

Shared Decision-Making in Solid Organ Transplantation: A Review

Solid organ transplantation entails numerous complex medical and ethical decisions. Shared decision-making (SDM) has been advocated as the optimal model for navigating these decisions, providing a collaborative framework that enhances person-centered care. This approach involves patients, caregivers, and healthcare professionals in the decision-making process, ensuring that clinical decisions align with patient preferences, values, and individual circumstances alongside clinical indications. This paper reviews the implementation of SDM throughout the transplantation journey, from diagnosis and transplant referral, pre-transplant assessments, waiting lists, to the organ offer, perioperative period, and long-term follow-up. Barriers to SDM include factors at the patient, provider, and system levels, including inadequate patient–provider communication. Effective SDM requires tailored educational resources, prognostic tools, clinician training, collaborative care models, and supportive policies. Additionally, leveraging technology, such as artificial intelligence and mobile applications, can enhance patient engagement and decision quality. SDM promotes equity by involving all patients—including those from more vulnerable groups—in meaningful conversations about their treatment options, thereby mitigating disparities in access and outcomes. Future research should focus on the long-term impacts of SDM interventions, the development of comprehensive prognostic tools incorporating patient-reported outcomes, and systemic changes to integrate SDM into clinical practice, aiming to improve patient outcomes and person-centered care.

Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting

IntroductionAdults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's “Be the Expert on You” note sheet, may require adaptations to address older adults' unique needs.MethodsWe recruited and partnered with older adult patients (n = 6) in focus group sessions to understand their perspectives on diagnostic communication and the existing AHRQ note sheet. A two-page communication and clinic workflow tool was developed and implemented over a 6-month period using three Plan-Do-Check-Act cycles. Physicians, nurses, staff, and patients were surveyed.ResultsMost older adult patients (n = 31) found the tailored diagnostic communication note sheet to be easy-to-use, helpful for provider communication, and would recommend its use to other patients. Physicians and staff members were satisfied with the note sheet and described few challenges in using it in practice.DiscussionOur findings contribute to the growing body of evidence around diagnostic safety interventions and patient engagement by demonstrating the feasibility and benefits of actively involving older adult patients in quality initiatives.

Enhancing primary healthcare delivery in Nigeria through the adoption of advanced technologies

Enhancing primary healthcare delivery in Nigeria by adopting advanced technologies holds substantial promise for improving healthcare accessibility, quality, and efficiency. Primary healthcare focuses on community-based, essential care that is practical, socially acceptable, and affordable. Despite efforts to improve healthcare delivery, challenges persist, particularly in rural and underserved areas. The aim of this study was to explore the transformative potential of technologies such as telemedicine, Electronic Health Records (EHRs), Health Information Systems (HIS), Artificial Intelligence (AI), and medical drones in addressing these challenges. Telemedicine facilitates access to healthcare in remote areas by overcoming geographical barriers. EHRs streamline administrative and clinical processes, enhancing patient care and safety. HIS improves data management, patient safety, and provider communication. AI revolutionizes diagnostics, treatment personalization, and operational efficiency. Medical drones offer innovative solutions for delivering medical supplies to remote locations. The paper also addresses the challenges associated with these technologies, including infrastructure limitations, regulatory issues, and data privacy concerns. Recommendations include investing in infrastructure, developing regulatory frameworks, building capacity, fostering public-private partnerships, engaging communities, and implementing robust data security measures. By addressing these recommendations, Nigeria can leverage advanced technologies to enhance healthcare delivery and achieve better health outcomes.

Assessment of Pregnant Women's Satisfaction With the Model of Care Initiative: Antenatal Care Services at Primary Health Care Centers in the Qassim Health Cluster, Saudi Arabia.

Patient satisfaction is a critical indicator of healthcare quality, including high-quality antenatal care (ANC), and it directly impacts care continuity and health outcomes. This study assessed the satisfaction levels of pregnant women with ANC services provided at primary healthcare centers (PHCs) within the Qassim Health Cluster, Saudi Arabia. A cross-sectional survey was conducted among 646 pregnant women attending ANC services in the Qassim region. Participants completed a validated questionnaire assessing demographic characteristics, healthcare interactions, and satisfaction levels across various ANC service aspects, including waiting times, healthcare provider communication, and healthcare service quality. Statistical analyses, including Pearson's chi-squared tests, Fisher's exact tests, and regression analyses, were performed to identify predictors of satisfaction. The majority of participants (N=366, 90.6%) reported successfully booking their appointments, and 368 (91.1%) faced no challenges during the process. While 393 (97.3%)and 398 (98.5%) reported receiving weight and blood pressure measurements, respectively, only 312 (77.2%) were advised on diet, and 298 (73.8%) received explanations about alarming symptoms. Communication gaps were noted, with 71% (N=287) of participants indicating that physicians did not introduce themselves, and 307 (76%) reported that physicians did not disclose their specialties. Satisfaction levels were highest for maintaining privacy (273 (67.6%) highly satisfied) and healthcare staff attitudes (247 (61.1%) highly satisfied), with an overall satisfaction mean score of 4.31±0.869. Regression analyses identified healthcare service levels and years of marriage as significant predictors of satisfaction (p<0.05). While overall satisfaction with ANC services was high, areas such as physician communication and health education require improvement. Interventions focusing on enhancing patient-provider interactions, providing comprehensive health education, and optimizing service delivery could further improve satisfaction.

Dental hygiene and dental students' patient communication skills: Is public speaking education relevant?

Commission of Dental Accreditation (CODA) Standards require graduates to be competent in patient-provider communication. The objectives were (a) to assess dental hygiene and dental students' general communication-related attitudes and self-reported skills related to establishing rapport, utilizing facilitative listening, and summarizing, as well as having oral health literacy-related expertise; (b) to evaluate students' prior public speaking experiences, their motivation to learn more about public speaking and evaluations of the public speaking-related educational intervention; (c) and explore the relationships between communication-related attitudes and skills and public speaking-related education. Anonymous web-based survey data were collected from 43 dental hygiene and 206 dental students after they participated in a zoom-based educational intervention entitled "Utilizing Public Speaking Principles in Patient-Dental Care Provider Communication: An Exploration." On average, dental hygiene and dental students had positive communication-related attitudes and agreed that communication is important (5-point answer scale: 5=agree strongly: dental hygiene students: Mean=4.00; dental students: Mean=4.08; p=0.487). Both groups agreed that they were comfortable with establishing rapport (3.98 vs. 4.08; p=0.151), summarizing information (3.92 vs. 3.86; p=0.309) and considering patients' oral health literacy skills in their communication (3.69 vs. 3.81; p=0.108). However, dental hygiene students agreed less than dental students that they had facilitative listening skills (3.84 vs. 4.00; p=0.034), had prior public speaking experiences (2.84 vs. 3.18; p=0.004) and were less motivated to learn more about public speaking (3.06 vs. 3.68; p<0.001). They also rated the educational intervention less positively than dental students (4.12 vs. 4.54; p<0.001). Patient communication skills correlated significantly with public speaking considerations. Students' communication-related attitudes are positive, but they are not likely to have education about public speaking. Dental educators should realize that students are interested in learning about public speaking and that learning about public speaking principles can enrich their patient-provider communication skills.

Physicians’ and nurses’ perceptions of the factors influencing the implementation of paediatric clinical pharmacy services in Hong Kong: a qualitative study

ObjectivesTo identify barriers and facilitators that influence the implementation of paediatric clinical pharmacy services in Hong Kong public hospitals from physicians’ and nurses’ perspectives.MethodsA qualitative study was conducted based on...

Double-Duty Caregivers' Satisfaction With Health Care Provider Communication.

Double-duty caregivers are health care professionals caring for family members or friends outside the workplace. While they may communicate frequently with colleagues in their professional role, little is known about communication with health care providers in the caregiving role. To measure double-duty caregiver satisfaction when communicating with health care providers and to identify correlates and predictors of satisfaction. A cross-sectional, nonexperimental, correlational study was used. Participants included registered nurses who were current or former caregivers of a family member or friend aged 50 or older. Correlation and multiple linear regression analyses were performed to examine the associations between double-duty caregivers' personal and professional attributes, factors, and satisfaction with communication. Double-duty caregivers reported above-average satisfaction with communication. Personal beliefs about caring and trust had the highest influence on satisfaction. Stress was associated with lower satisfaction with communication. This study is the first to examine double-duty caregiver satisfaction when communicating with health care providers and associated factors. Health care providers must implement strategies to maximize their acknowledgment of personal beliefs about caring and foster the building of trusting relationships to support colleagues in this role.

Strengthening Consumer Loyalty by Provider Communication Products In Industry 4.0

In this study, the influence of perceived value on consumer loyalty and the impact of marketing mix communication on both will be investigated. This study also considers how perceived value mediates the influence of marketing mix communication on consumer loyalty. 125 By.U mobile card consumers in Bandung, West Java, received surveys from researchers using quantitative methods. The data were analyzed using SmartPLS 3.0 structural equation modeling. The positive impact of Marketing Mix Communication on consumer loyalty and perceived value is demonstrated in this study. Perceived value also impacts consumer loyalty. This study also provides evidence supporting the idea that the relationship between marketing mix communication and consumer loyalty is mediated by perceived value.

The role of cultural competence in health care to improve communication between immigrant patients and health-care providers in Ottawa, Canada

Purpose Cultural competence has been recognized as an essential process in reducing racial and ethnic health-care disparities and improving equity in health care. Recent immigrants to Canada encounter a different and unfamiliar health-care system. This study aims to focus on examining the role of cultural competence in improving communication between immigrant patients and their health-care providers. Design/methodology/approach Using an exploratory approach, four focus group discussions with a sample of recent immigrants were conducted to gain insights from immigrant patients’ perspectives with regard to communicating with their health-care providers. The focus group discussions were analyzed using a thematic analysis approach. Campinha-Bacote’s Cultural Competence Model was used for this study as its theoretical framework. Findings The focus group findings revealed that the lack of cultural competence among health-care providers and language barriers are major issues that impact the health-care experiences of immigrant patients. Health-care organizations may use these findings to better inform their decision-making with regard to effective patient–provider communication. Originality/value This study advances the line of research that examines patient–provider communication by adding diverse immigrant patients’ perspectives. The findings can inform the design of cultural competence strategies for health-care organizations.

Healthcare provider communication and current contraceptive use among transgender men and gender-diverse people: Results from an online, cross-sectional survey in the United States.

To explore whether discussing contraceptive use with a healthcare provider is associated with current contraceptive use among transgender men and gender-diverse (TMGD) individuals. In 2019, we conducted a cross-sectional survey among transgender men and gender-diverse adults in the United States who were assigned female or intersex at birth. We measured whether respondents had ever discussed contraception with a healthcare provider as well as current use of contraception, reasons for use, and barriers to use. We described frequencies and ranges for key variables and implemented a series of nested logistic regression models to evaluate the association between ever having spoken to a provider about contraception and current use of contraception for any reason, overall and by method type. Among 1694 respondents, about half (48%) were currently using a method of contraception for any reason, most commonly barrier methods (17%) and long-acting-reversible-contraception (LARC) (17%). Compared to those who never had a conversation about contraception with a provider, respondents who spoke with a provider were more likely to be currently using contraception - particularly among those who self-initiated the conversation (aOR: 3.8, 95% CI: 2.5-5.6). Having discussed contraception with a healthcare provider was most strongly associated with current LARC use. Having had a conversation with a provider about contraception use was positively associated with current contraception use among a large, national sample of transgender men and gender-diverse people. Facilitating patient participation in contraception counseling for transgender and gender-diverse patients should be emphasized in provider training. Given formidable barriers to healthcare faced by TMGD people, training providers on how to initiate affirming and relevant conversations with TMGD patients about contraceptive needs and preferences is essential, as are efforts to educate and empower TMGD individuals to advocate for the information they need in these interactions.

“If they take it without knowing, they will default…”: perceptions of targeted information transfer to promote adherence to intermittent preventive treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy in western Kenya

BackgroundIncreasing resistance to sulfadoxine-pyrimethamine (SP) threatens the effectiveness of intermittent preventive treatment (IPTp) to prevent malaria in pregnancy. Dihydroartemisinin-piperaquine (DP) is the most promising candidate to emerge from clinical trials, but requires a multi-day regimen. Despite being a single-dose regimen, coverage of IPTp-SP remains low, fuelling concerns about adherence to multi-day drug options. An implementation feasibility trial in routine antenatal care settings in western Kenya demonstrated that adherence to the multi-day DP regimen was improved when IPTp-DP was delivered with a targeted information transfer intervention that comprised healthcare provider training and communication tools to support delivery and uptake. This study explored healthcare provider and pregnant women perspectives to understand (1) how the targeted information transfer improved adherence to IPTp-DP and (2) if improved adherence to IPTp-DP influenced provider perceptions towards implementation feasibility of multi-day drug regimens for IPTp.MethodsIn-depth interviews were conducted with 64 healthcare providers and 64 pregnant women, selected using a convenience sampling approach from across the three trial arms: IPTp-DP+ (with intervention), IPTp-DP, and current standard of care IPTp-SP. Transcripts from healthcare providers and pregnant women were coded in Nvivo-12 using separate a priori frameworks that included components of the consolidated framework for implementation research. Thematic analysis was used to understand how the targeted information transfer affected adherence to IPTp-DP and how concerns about adherence might influence provider perceptions towards multi-day drug regimens for IPTp.ResultsAdherence to IPTp-DP doses taken at home was compromised when women experienced unpleasant side effects. Pregnant women valued being given information about IPTp-DP, including potential side effects and how to manage them. Among providers in the IPTp-DP + arm, confidence in advising women on how to manage side effects increased, and they believed this guidance improved adherence. When concerns about adherence were reduced, providers in the IPTp-DP + arm were positive about implementation feasibility, whereas providers in the IPTp-SP arm remained focused on the dosing complexities and were less convinced of the feasibility of implementing IPTp-DP.ConclusionsHealthcare provider confidence in advising women on how to minimize side effects was boosted through targeted information transfer, which was perceived to improve adherence to IPTp-DP. Policy makers are encouraged to consider supportive interventions that enhance provider confidence around adherence should they shift to multi-day drug regimens for IPTp.

Patients’ perception of quality of care in health facilities empanelled under Sehat-Card-Plus programme, in Khyber-Pakhtunkhwa, Pakistan

Objective:This study aims to assess perceived quality of care among users of hospitals empanelled under SCP Programme,KP.Methods: The assumed satisfaction level was 80% among SCP users, and 10%-point lower satisfaction among SCP nonusers.With a design effect of 1.5, 95% confidence level, and 80% power, the estimated total sample size was 972 patients,with equal group sizes of SCP users and SCP non-users. However, a total of 1,006 patients were included in the study, ofwhich 517 were SCP users and 489 were non-SCP users. Total samples were distributed across 38 facilities in KP, proportionalto average monthly admissions at each sampled facility. The data collection tool included 18 indicators of perceived qualityof care, spread across 6 domains.Results:The overall satisfaction level with the quality of care among SCP users was found higher, 81%, relative to non-users,79% (p&lt;0.001). Disaggregated analysis across the study domains showed that the SCP non-users expressed higherperception about quality of hospital infrastructure and amenities relative to SCP users, whereas SCP users reported highersatisfaction with promptness of service, healthcare provider conduct, healthcare provider communication and quality ofhealth service delivery. Only 326 (63%) users and 299 (61%) non-users were satisfied with healthcare providercommunication. A total of 344 (67%) SCP users reported that Sehat Card Desk Representative gave them completeinformation about benefits and services under the programme.Conclusions: The SCP users reported high perceived quality of care. Further in-depth qualitative assessment isrecommended to explain these findings.Keywords: Social health insurance, Quality of care, Sehat Card Plus Programme, Patient satisfaction, Khyber Pakhtunkhwa

Disclosure Practices in Muslim Patients and the Impact on End-of-Life Care: A Narrative Review.

Context: Non-disclosure practices hold significant weight in end-of-life care for Muslim communities, where cultural and religious beliefs are deeply intertwined with healthcare decision-making. This narrative review explores the complexities of medical decision-making and disclosure practices among terminally ill Muslim patients, examining how these factors shape palliative care delivery. Objectives: The primary objective of this review is to investigate the impact of non-disclosure practices on end-of-life care in Muslim populations, focusing on key themes that influence medical decision-making. Additionally, the review identifies ways in which Healthcare Provider (HCP) can navigate these culturally sensitive issues to enhance care. Methods: A comprehensive narrative review was conducted, utilizing articles from CINHAL, PsychINFO, Scopus, and PubMed databases published between 2009 and 2024. An initial search yielded 2025 articles. After applying inclusion and exclusion criteria, 12 studies were included for analysis. The SANRA guidelines for narrative reviews were followed, and the SPIDER framework was used for qualitative synthesis. Results: Of the 2041 articles initially retrieved, 2014 were excluded after screening, 8 were duplicates, and 7 full texts were excluded for not meeting the inclusion criteria. The final review included 12 studies. Three key themes emerged: (1) cultural, religious, and emotional factors driving requests for non-disclosure, (2) the prominent role of family in medical decision-making, and (3) healthcare provider communication challenges contributing to disparities in palliative care access. Conclusion: Non-disclosure practices present significant barriers to effective palliative care in Muslim communities. To improve care outcomes, culturally competent communication strategies and family-centered decision-making models are crucial.

Evaluating Patient Portals for Patients with Visual or Hearing Impairments: Provider Confidence and Communication Challenges

Evaluating Patient Portals for Patients with Visual or Hearing Impairments: Provider Confidence and Communication Challenges

Effect of Improved Provider Communication and Adherence to Guidelines on PrEP Initiation in Kisumu Kenya

Introduction: Adolescent girls and young women (AGYW) in Kenya have low pre-exposure prophylaxis (PrEP) initiation rates in part due to stigmatizing interactions with health care providers. Our recent randomized clinical trial of a standardized patient actor (SP) training intervention for providers found higher quality PrEP delivery at intervention sites, however it was unclear whether improved service quality improved PrEP initiation. Methods: This analysis used routine records from facilities participating in the randomized trial which aimed to improve provider communication and adherence to Kenyan guidelines when offering PrEP to AGYW. We utilized facility-level PrEP registers from May-December 2019 as the baseline period and December 2020-June 2021 as the post-intervention period. We used linear regression with percent initiating as the outcome, intervention and baseline initiation levels as covariates, and the number eligible post-intervention at each facility as frequency weights. Results: Overall, 1,375 AGYW presented to study sites, were eligible for PrEP, and were included in analyses (baseline: n=706, post-intervention: n=669). Among 669 PrEP-eligible AGYW in the post-intervention period (intervention: n=360, control: n=309), 591 (88.3%) initiated PrEP (intervention: n=335, control: n=256). PrEP initiation was 93.1% at intervention sites (range: 0%-100%) and 82.8% at control sites (range: 0%-100%). Adjusted for baseline initiation rates, initiation was 12.1% higher at intervention sites compared to control sites (p&lt;0.001, [95% CI: 0.09, 0.15]). Conclusions: Our study found significant improvement in PrEP initiation among AGYW who presented to intervention facilities. SP training interventions that improve quality of service delivery for AGYW could lead to higher population-level PrEP coverage.

Perceived barriers and facilitators to HPV vaccination: Insights from focus groups with unvaccinated mid-adults in a U.S. medically underserved area

ABSTRACT Shared clinical decision-making (SCDM) about HPV vaccination has been recommended for U.S. mid-adults aged 27–45 since 2019. To explore barriers and facilitators to HPV vaccination in this population, we conducted 14 virtual focus groups with 86 unvaccinated mid-adults (34 men and 52 women) in California’s medically underserved Inland Empire between September 2020 and January 2021. We systematically analyzed the focus group data using the rigorous and accelerated data reduction (RADaR) technique to identify key themes. Identified barriers included: lack of awareness, vaccine hesitancy, and perceived unaffordability (cited in 14 groups); lack of healthcare provider communication and insufficient time (13 groups); fear of moral judgment (12 groups); lack of motivation and information needs (10 groups); and lack of reliable transportation and foregone care during the COVID-19 pandemic (3 groups). Proposed facilitators included: tailored HPV vaccine information for mid-adults, cost mitigation, and improved vaccine accessibility (12 groups); healthcare provider-initiated conversations (6 groups); and vaccine reminders (4 groups). These findings highlight challenges to HPV vaccination among U.S. mid-adults eligible for SCDM and point to actionable strategies for improvement. Specifically, tailored educational interventions, decision-making tools for pharmacists, and integrating HPV vaccination into other healthcare encounters may enhance vaccination efforts in areas with limited primary care resources.

Abstract 4118668: Understanding Medication Adherence to Oral Anticoagulants in Atrial Fibrillation Management: Patient and Provider Perspectives in a Mixed Methods Study

Background: Atrial fibrillation (AF) increases risk of stroke. National guidelines recommend oral anticoagulant (OAC) use to reduce this risk. Medication adherence is pivotal for effective AF management, necessitating an understanding of adherence barriers. Aims: This mixed-methods study aimed to identify patient and provider factors influencing OAC adherence. Methods: Patients with nonvalvular AF and OAC prescriptions were sampled from a large community health system serving seven states. A stratified random sample of 2,000 patients was surveyed by mail, achieving a 13.3% response rate (266 patients). Twenty-eight semi-structured interviews were conducted with a purposive sample of patient survey respondents. Eligible providers were surveyed by email, resulting in a 3% response rate (78 providers). Survey data were analyzed descriptively and using multivariable regression models. Interview data were analyzed thematically. Results: Of 213 patients with an adherence score available, 31.5% reported non-adherence. Nonadherent patients were more likely to report poor healthcare experiences, including discrimination in a healthcare setting and poorer mental/emotional health. Receiving information from providers was significantly associated with adherence, especially among younger patients and those with fewer chronic conditions. High self-efficacy score was associated with adherence, particularly among older and rural patients. Interview analyses showed provider communication about AF medications, perceptions of AF as a serious illness, and a sense that medication was helping manage AF were all important for medication adherence. In contrast, most providers (87%) perceived high non-adherence among AF patients, citing forgetfulness, cost, and side effects as the main reasons. Providers’ responses indicate a need for improving communication and support for addressing adherence barriers. Conclusion: Most patients reported adherence to their medications, with adherence being associated with positive healthcare experiences and better mental/emotional health. Providers perceived relatively low adherence among their patients but aligned with patients on the need for improved communication and shared decision making. Tools that encourage discussion with patients and open communication between providers and patients are pivotal for optimizing patient care and enhancing medication adherence and treatment outcomes.

Power and racial differences in the communication experiences of Black and White patients living with advanced cancer and their care partners: An application of co-cultural theory

ABSTRACT We investigated power imbalances in racially discordant medical interactions in the context of advanced cancer care within the United States. We applied co-cultural theory to the transcripts of 43 interviews conducted with Black and White cancer patients and their care partners. We found Black patients and care partners perceived providers as dismissing their concerns. In response, they engaged in extensive preparation, rationalization, and utilizing liaisons. White patients and care partners recognized and took advantage of their privilege and utilized liaisons. Some patients acquiesced and conferred with others in response to power enacted by oncologists. We concluded co-cultural theory is useful in explaining what occurs in racially discordant patient-provider interactions. Our findings highlight the need for provider communication and de-biasing training. Trial registration: ClinicalTrials.gov identifier: NCT03780816..

HBV Transmission Knowledge Among Korean-American Chronic Hepatitis B Patients in the United States.

Chronic hepatitis B (CHB) is a condition that disproportionately affects Asian Americans in the United States. Knowledge of transmission is crucial for CHB patients to practice prevention methods to limit the spread of the hepatitis B virus (HBV), but also live their lives free from unwarranted fears or restrictions. Among Asian CHB patients, several misperceptions about HBV transmission have been identified. This analysis aims to assess the current state of HBV knowledge among a cohort of Korean-American CHB patients. This mixed-methods study includes 363 respondents who completed a survey in either Korean (N = 298) or English (N = 65) at two clinical care settings in Philadelphia (N = 161) and Los Angeles (N = 202); 30 participants also completed in-depth interviews. Knowledge was measured on a 10-point scale, asking patients yes or no transmission questions (n = 10, alpha = 0.87). The average knowledge score was 6.3. In multivariate analyses, older age was associated with lower knowledge (β=-0.25, p < 0.001). More years of formal education (β = 0.09, p = 0.076) and utilizing more sources for health information (β = 0.12, p = 0.023) were both independently associated with higher knowledge scores. Qualitative findings show that misperceptions about transmission through shared food still exist and that provider communication is an important part of knowledge acquisition. These results suggest that despite receiving specialized, culturally concordant medical care for their disease, some Korean-American CHB patients have an inadequate understanding of transmission and that opportunities exist to improve education in this population. Identifying additional factors that influence knowledge acquisition and retention is key to developing culturally effective education interventions for this population.