This paper assesses whether 2 dimensions of whites' and blacks' attitudes toward race concordance with doctors are associated with past unfair treatment in health care and general racial attitudes, and whether the association varies by race. Using telephone survey data, we find that among blacks, but not whites, more positive attitudes toward race-concordant doctors are associated with past unfair treatment in health care related to doctor race. In addition, we find that among whites, but not blacks, more positive attitudes toward race concordance are associated with negative attitudes toward interracial contact in general. We conclude that these dimensions of blacks' and whites' attitudes toward health care are associated with distinct factors. The findings encourage research on how attitudes formed outside health care, as well as how health care experiences influence attitudes toward health care and how these factors may vary by location in the system of racial inequality.
"In addition to the aforementioned barriers to OCD treatment, there may be additional barriers experienced uniquely by African Americans. For example, research has noted that many African Americans prefer a counselor of the same race (Malat, Purcell, & van Ryn, 2010), which may present a barrier to treatment as African Americans are underrepresented among clinical psychologists . This preference may protect African Americans against the psychological effects of racial discrimination, but prevent the initiation of needed services (Whaley, 2001). "
[Show abstract][Hide abstract] ABSTRACT: African Americans are underrepresented in OCD treatment centers and less likely to experience a remission of symptoms. This study examines the barriers that prevent African Americans with OCD from receiving treatment. Seventy-one adult African Americans with OCD were recruited and administered the modified Barriers to Treatment Participation Scale (BTPS) and the Barriers to Treatment Questionnaire (BTQ). Comparing the BTQ between a European American Internet sample (N=108) and the African American OCD sample (N=71) revealed barriers unique to African Americans, including not knowing where to find help and concerns about discrimination. A Mokken Scale Analysis of the BTPS in the African American participants identified seven major barriers, including the cost of treatment, stigma, fears of therapy, believing that the clinician will be unable to help, feeling no need for treatment, and treatment logistics (being too busy or treatment being too inconvenient). Pearson and point-biserial correlations of the scales and demographic and psychological variables were conducted. Significant relationships emerged between age, gender, income, education, insurance status, and ethnic affirmation/belonging among several of the Mokken scales. A one-way ANOVA demonstrated that concerns about cost were significantly greater for those without insurance, versus those with public or private plans. Suggestions for overcoming barriers are presented, including community education, affordable treatment options, and increasing cultural competence among mental health providers.
[Show abstract][Hide abstract] ABSTRACT: Non-verbal communication is an important aspect of the diagnostic and therapeutic process, especially with older patients. It is unknown how non-verbal communication varies with physician and patient race.
To examine the joint influence of physician race and patient race on non-verbal communication displayed by primary care physicians during medical interviews with patients 65 years or older.
Video-recordings of visits of 209 patients 65 years old or older to 30 primary care physicians at three clinics located in the Midwest and Southwest.
Duration of physicians' open body position, eye contact, smile, and non-task touch, coded using an adaption of the Nonverbal Communication in Doctor-Elderly Patient Transactions form.
African American physicians with African American patients used more open body position, smile, and touch, compared to the average across other dyads (adjusted mean difference for open body position = 16.55, p < 0.001; smile = 2.35, p = 0.048; touch = 1.33, p < 0.001). African American physicians with white patients spent less time in open body position compared to the average across other dyads, but they also used more smile and eye gaze (adjusted mean difference for open body position = 27.25, p < 0.001; smile = 3.16, p = 0.005; eye gaze = 17.05, p < 0.001). There were no differences between white physicians' behavior toward African American vs. white patients.
Race plays a role in physicians' non-verbal communication with older patients. Its influence is best understood when physician race and patient race are considered jointly.
Journal of General Internal Medicine 12/2011; 27(5):576-81. DOI:10.1007/s11606-011-1934-z · 3.42 Impact Factor
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