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The article presents a study conducted by the American Academy of Family Physicians National Research Network (AAFP NRN) which looks into the question-asking behavior of patients through Ask Me 3 (AM3) health communication program during the primary care visits in the U.S. The study gain no evidence of proving the rate of questions asked by patients or better medication compliance using the AM3 intervention. It reveals that the use of specific, personalized intervention could be more effective.

Abstract: Objective: The goal of this study is to add to a small, but growing body of research exploring how patients’ communication style affects physicians’ communication. In particular, we examine how patients’ active participation (e.g., asking questions, providing information) affects physicians’ use of patient-centered communication. Methods: The same 25 physicians were observed interacting with high and low participation patients. High participation was defined as the frequency of information seeking/verifying, information provision, assertive utterances, and expressing concerns. On average, physicians interviewed 2.56 high participation patients and 3.44 low participation patients. Transcripts of the interviews were coded for physicians’ patient-centered communication. High and low patient participation interviews were then compared using nested ANOVAs. Results: When interacting with high participation patients, physicians engaged in significantly more patient-centered communication overall than when interacting with low participation patients. Analyses on separate components of patient-centeredness indicated that physicians engaged in significantly more exploring of patients’ disease and illness, but did not engage in significantly more understanding of the whole person or finding of common ground. Conclusion: Patients who actively participate in medical interviews influence physicians to adopt a more patient-centered style of communication. [Copyright &y& Elsevier]

Several factors affect observed racial/ethnic health disparities in the United States. Among them are features of provider-patient communication. In Study 1, the literature in patient communication skills training is reviewed to determine the extent to which researchers have reported comparative effects of interventions designed to enhance patients' communication skills and participation in medical interviews. Of the 27 studies reported, only 1 conducted a comparative analysis. In Study 2, a post hoc analysis of available communication skills training data sets is conducted to explore comparative intervention effectiveness. Similar to the results of the single report found in Study 1, the communication intervention was more effective with White than with non-White patients. These results are discussed with respect to implications for addressing racial/ethnic health disparities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To test the effects of a communication skills training intervention on older patients' discourse during a primary care interview. DESIGN: A quasi-experimental design involving two intervention conditions. SETTING: The Family Practice Center of a university-based clinic. PARTICIPANTS: Thirty-three patients averaging age 72 and 9 family practice physicians. INTERVENTION: A communication skills training booklet received approximately 3 days before the scheduled appointment and a 30-minute face-to-face follow-up session before seeing the physician. MEASUREMENTS: Patients' seeking, providing, and verifying of information were coded from transcripts of the 33 interviews. RESULTS: Trained patients engaged in significantly more seeking and providing of information than untrained patients. Additionally, trained patients obtained significantly more information from physicians than did untrained patients, both in terms of the number of total information units and the number of units per question asked. CONCLUSION: Patient communication skills training appears to be an effective means of enhancing patients' participation in the medical interview without increasing the overall length of the interview. [ABSTRACT FROM AUTHOR]

An abstract of the article "Student dissatisfaction with an integrated community health education service learning project," by Douglas M. Post and colleagues is presented.

Objective: To explore Appalachian women's perceptions of trust and distrust of healthcare providers and the medical care system as they relate to views about cervical cancer and screening. Methods: Thirty-six Ohio Appalachia female residents participated in community focus groups conducted by trained facilitators. Discussion topics included factors related to cervical cancer, and the issues of trust and distrust in medical care. The tape-recorded focus groups were transcribed and analyzed to identify salient themes. Results: Five themes emerged related to trust in healthcare. Patient-centered communication and encouragement from a healthcare provider led women to trust their physicians and the medical care system. In contrast, lack of patient-centered communication by providers and perceptions of poor quality of care led to distrust. Physician gender concordance also contributed to trust as women reported trust of female physicians and distrust of male physicians; trust in male physicians was reported to be increased by the presence of a female nurse. Conclusions: Important factors associated with trust and distrust of providers and the medical care system may impact health-seeking behaviors among underserved women. Practice implications: Opportunities to improve patient-centered communication around the issues of prevention and cervical cancer screening (such as providing patient-focused information about access to appropriate screening tests) could be used to improve patient care and build patients’ trust. [Copyright &y& Elsevier]

Objective: Patient-clinician communication difficulties are a major barrier to effective symptom management during chemotherapy especially among non-English-speaking and minority patients. This study sought to examine how information is exchanged between patients and clinicians during chemotherapy treatment regarding pain, depression, fatigue, and nausea experienced among the most prevalent non-English-speaking group in the USA, Hispanic breast cancer survivors.Methods: Hispanic breast cancer patients and clinicians participated in focus groups to examine Hispanic breast cancer survivors' experience and patient-physician communication of symptoms during chemotherapy. Three separate focus groups (English language with patients, Spanish language with patients, and English language with clinicians) were conducted. All participants completed a demographic questionnaire.Results: Six breast cancer survivors participated in the English-language focus group, ten breast cancer survivors participated in the Spanish-language focus group, and five clinicians participated. Presence and communication of depressive symptoms between the English- and Spanish-language groups differed, with the majority of the English-language group sharing their experiences of depressive symptoms while those in the Spanish-language group did not report depressive symptoms. Results also indicated that most patients were unhappy with the response of clinicians regarding their reported symptoms. Several barriers to effective patient-clinician communication, including limited physician time, lack of patient knowledge, timidity, and language, were identified.Conclusion: The findings of this study underscore the need to improve patient-physician communication during chemotherapy to reduce the symptom burden among Hispanic breast cancer patients. [ABSTRACT FROM AUTHOR]

Effective strategies are needed to address the health behaviors of older patients with diabetes. One approach is health coaching, the practice of health education and health promotion through a structured partnership designed to enhance well-being and facilitate the achievement of individuals' health-related goals. The aim of this study was to describe the development of a pilot health coaching curriculum, investigate its effects on geriatric patient outcomes, and examine qualitative feedback by older patients and medical students to the curriculum. This mixed-methods study involved 29 first-year medical students randomly paired with 29 older adults with uncontrolled Type 2 diabetes. Health-related quality of life (HRQoL), stage of change movement, diabetes knowledge, locus of control, Body Mass Index (BMI), and glycosylated hemoglobin (HbA1c) were assessed. Focus groups were used to evaluate patients' and medical students' experiences. Results showed significant increases in patients' HRQoL and stage of change for exercise improved significantly over time. There were no significant changes in stage of change for healthy diet and medication, diabetes knowledge, BMI, and HbA1c from baseline to end of study. Focus group data indicated positive responses by older patients and the medical students. A health coaching curriculum may improve patient outcomes and can provide medical students the skills needed to provide compassionate care for geriatric patients. [ABSTRACT FROM AUTHOR]

The article covers a study examining the social networks of rural women based on whether they did or did not smoke. Details are provided from a survey of adult women from Ohio Appalachian counties which recorded time women spent with social networks as well as time spent giving or receiving advice. The authors go on to discuss how this study can be used to in the development of a network-based smoking cessation intervention.

Abstract: Objective: We describe factors, in the context of the Social Determinants of Health model, associated with receiving Pap smears within risk-appropriate guidelines (i.e., guidelines that specify screening intervals based upon a woman''s individual risk of developing cervical cancer). Methods: Completed in June 2006, we conducted a cross-sectional survey of women from 14 health clinics in Ohio Appalachia pertaining to psychosocial, demographic, biological, and health-related factors. A logistic regression model was constructed to predict whether or not a woman was within risk-appropriate cervical cancer screening guidelines. Results: Of 562 women with a date of last Pap smear, 380 (68%) were within risk-appropriate guidelines. Logistic regression showed that, compared to women with low-level SES, women with middle- and high-level SES had 3.39 [1.85, 6.21] and 3.86 [2.03, 7.34] times the odds, respectively, of being within risk-appropriate guidelines. Odds of being within guidelines increased 1.09 [1.04, 1.15] fold for each decrease of one major life event. Additionally, women that were financially better off or financially worse off than their parents at the same age had lower odds (0.41 [0.23, 0.73] and 0.49 [0.24, 0.98], respectively) of being within guidelines than women who reported their finances were the same as their parents. Results also showed an interaction between marital status and age at first intercourse (p =0.001). Conclusion: The results suggest an impact of psychosocial factors on Pap smear testing behaviors, and illustrate the need to examine risk-appropriate interventions to improve screening. [Copyright &y& Elsevier]

Abstract: To assess HPV vaccine acceptability, focus groups of women (18–26 years), parents, community leaders, and healthcare providers were conducted throughout Ohio Appalachia. Themes that emerged among the 23 focus groups (n =114) about the HPV vaccine were: barriers (general health and vaccine specific), lack of knowledge (cervical cancer and HPV), cultural attitudes, and suggestions for educational materials and programs. Important Appalachian attitudes included strong family ties, privacy, conservative views, and lack of trust of outsiders to the region. There are differences in HPV vaccine acceptability among different types of community members highlighting the need for a range of HPV vaccine educational materials/programs to be developed that are inclusive of the Appalachian culture. [Copyright &y& Elsevier]