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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. Keywords: health disparities; racial/ethnic; patient communication; patient participation

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.

The article presents a study which tested the Ohio American Cancer Society model of patient navigation with respect to reducing time to diagnostic resolution. Patients with abnormal breast, cervical or colorectal cancer screening tests from 18 clinics participated in the group-randomized trial. The study revealed that participants resolved faster when assigned to patient navigation. The effect of patient navigation became apparent starting six months after detection of the abnormality.

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]

The article reports on the results of a study conducted at the Ohio State University College of Medicine (OSU COM) which describe 20 years of experience with a required service learning curriculum entitled "Community Project" (CP). The study includes tracking of the total numbers of students devote to service-learning projects and to assess student involvement in service learning courses. Results of the study show that service-learning curricula can improve health care and help medical students grow personally and professionally. The study also cites that students from OSU COM benefited from the 20-year history with service-learning education.

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]

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]