Mobile-based patient-provider communication in cancer survivors: The roles of health literacy and patient activation

Purpose: Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer. Methods: Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from “did not discuss” to “discussed in detail,” a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses. Results: At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married. Conclusion: Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.

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The Role of Patient Activation on Patient–Provider Communication and Quality of Care for US and Foreign Born Latino Patients

Journal of General Internal Medicine ◽

10.1007/s11606-009-1074-x ◽

2009 ◽

Vol 24 (S3) ◽

pp. 534-541 ◽

Cited By ~ 81

Author(s):

Margarita Alegría ◽

William Sribney ◽

Debra Perez ◽

Mara Laderman ◽

Kristen Keefe

Keyword(s):

Quality Of Care ◽

Patient Activation ◽

Provider Communication ◽

Foreign Born ◽

Patient Provider Communication

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Development of a Clinical-Academic-Community Collaboration to Improve Health Literacy

Journal of Primary Care & Community Health ◽

10.1177/2150132720957440 ◽

2020 ◽

Vol 11 ◽

pp. 215013272095744

Author(s):

Daniela B. Friedman ◽

Michelle A. Arent ◽

Brooks Yelton ◽

Mayank Sakhuja ◽

Venice E. Haynes ◽

...

Keyword(s):

Health Literacy ◽

Academic Community ◽

Lessons Learned ◽

Provider Communication ◽

Medical Terminology ◽

Readiness Assessment ◽

Community Partners ◽

Patient Health ◽

Patient Provider Communication ◽

Pilot Intervention

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ motivation and capacity for pilot implementation and providers’ current communication strategies. The intervention centered around AskMe3™ educational materials and involved 2 patient visits (initial and follow-up visits). Data collection instruments for the intervention were administered verbally and included questions about patient demographics and communication needs, and a single-item health literacy measure. Descriptive statistics (frequencies/percentages) were used to analyze results from the clinic readiness assessment and pilot intervention. Establishment of the partnership, and collaborative, iterative development of the clinic readiness assessment and pilot intervention are described. This pilot project resulted in important lessons learned which led to critical modifications that will inform future expansion of the intervention. Collaboration between healthcare leaders, researchers, and community partners is recommended for developing clinic-based health literacy initiatives.

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Associations Between Baseline PROMIS Scores, Patient-Provider Communication Factors, and Musculoskeletal Health Literacy on Differences in Patients’ and Surgeons’ Expectations in Foot and Ankle Surgery

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00057 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0005

Author(s):

Aoife MacMahon ◽

Elizabeth Cody ◽

Kristin C. Caolo ◽

Jensen K. Henry ◽

Mark C. Drakos ◽

...

Keyword(s):

Decision Making ◽

Health Literacy ◽

Pain Intensity ◽

Patient Perceptions ◽

Provider Communication ◽

Foot And Ankle ◽

Musculoskeletal Health ◽

Ankle Surgery ◽

Patient Reported ◽

Patient Provider Communication

Category: Other Introduction/Purpose: Aligning patient and surgeon expectations is important, as it allows for informed and shared decision- making and may improve postoperative satisfaction. Patient-provider communication factors have been found to affect differences between patient and surgeon expectations of total knee arthroplasty. Patients with limited health literacy have been found to ask fewer questions and spend less time with their surgeons, and to perceive themselves to have a more passive decision-making role in hand surgery clinic visits. Understanding how these factors affect differences in expectations of foot and ankle surgery is important in order to increase patient-surgeon agreement. This study aimed to assess associations between patient-reported physical and mental status, patient-surgeon communication factors, and musculoskeletal health literacy with differences between patient and surgeon expectations of foot and ankle surgery. Methods: Two hundred two patients scheduled to undergo foot or ankle surgery by one of seven fellowship-trained foot and ankle surgeons at an academic hospital were enrolled. Preoperatively, patients and surgeons completed the Hospital for Special Surgery Foot & Ankle Surgery Expectations Survey independently. Patients also completed Patient-Reported Outcomes Measurement Information System (PROMIS) scores in Physical Function, Pain Interference, Pain Intensity, Depression, and Global Health. Patient involvement in care, provider partnership building, and provider information giving were assessed with the modified Patients’ Perceived Involvement in Care Scale (PICS). Musculoskeletal health literacy was assessed with the Literacy in Musculoskeletal Problems (LiMP) questionnaire. A score >= 6 reflects adequate musculoskeletal literacy and a score < 6 reflects limited musculoskeletal literacy. Associations between scores and differences between patient and surgeon expectations were assessed with Pearson Correlation coefficients. Associations between musculoskeletal health literacy and differences were assessed with Student’s t-tests and Mann Whitney U tests. Results: Greater differences in patient and surgeon overall expectations scores were associated with worse PROMIS scores in Physical Function (p = 0.003), Pain Interference (p = 0.001), Pain Intensity (p = 0.009), Global Physical Health (p < 0.001), and Depression (p = 0.009). A greater difference in the number of expectations between patients and surgeons was associated with all of the above (p <= 0.003) and with worse Global Mental Health (p = 0.003). Patient perceptions of higher surgeons’ partnership building were associated with a greater number of patient than surgeon expectations (r = 0.170, p = 0.017) (Table 1). There were no associations found between LiMP scores or adequate/limited musculoskeletal literacy and differences in expectations (p >= 0.155). Conclusion: Worse baseline patient physical and mental status and higher patient perceptions of provider partnership building were associated with greater patient to surgeon differences in expectations of foot and ankle surgery. It may be beneficial for surgeons to set more realistic expectations with patients who have greater disability and in those whom they have stronger partnerships with in order to increase agreement in expectations. Further studies are warranted to understand how modifications in patient and surgeon interactions affect agreement in their expectations of foot and ankle surgery, and whether musculoskeletal literacy affects these interactions. [Table: see text]

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