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Structural disparities (eg, food insecurities, housing, and lack of transportation) at different social levels (eg, personal, family, and community) are strong determinants of health, influencing individuals' and population well-being worldwide. Research is scarce examining how clinical communication can mitigate the negative impact of social disparities obstructing the reception of quality healthcare. In this study, we explore the mediation role of patient-centered communication (PCC) between social determinants of health (SDH) and quality of care. Using a sample of 5437 adult who visited a healthcare provider in the past 12 months from the sixth Health Information National Trends Survey (HINTS 6), our key points of findings included that the models showed PCC partially mediating the connections from (a) "skipped meals" (effect = −.08, 95%CI = [−.12, −.04]), (b) "unaffordable meals" (effect = −.08, 95%CI = [−.11, −.05]), (c) "fear of eviction" (effect = −.1, 95%CI = [−.14, −.06]), and (d) "lack of transportation" (effect = −.12, 95%CI = [−.16, −.08]) to quality of care (QoC). Specifically, better communication had a positive impact on mediating the disparities; poor communication did not. Demonstrating in a nationally representative sample, our findings indicate the key role of patient-centered clinical communication in effectively alleviating the inherent challenges faced by people with low health literacy and socioeconomic status. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

This study used the Medical Expenditure Panel Survey data (2010-2018) to examine associations between diabetes patients' satisfaction with their provider and ratings of healthcare received, diabetes care self-efficacy, and monitoring adherence among nonpregnant reproductive age women with diabetes. The sample included nonpregnant women of childbearing age (18-45) with diabetes mellitus (n = 767; weighted n = 1.3 million women). The results indicated that patients who reported that their usual care provider always asked/showed respect for medical, traditional, and alternative treatments that the person is happy with had 2.59 times greater odds (95% confidence interval [CI]:1.32-5.10) of giving high ratings of healthcare (8-10) compared to those whose provider did not show respect for treatments. Results also showed that patients who reported they were asked to decide between a choice of treatments had 1.76 greater odds (95% CI:1.03-3.01) of diabetes care monitoring adherence. Findings demonstrate the importance of patient-centered communication experiences in relation to diabetes care monitoring adherence. Implications of the findings for clinical encounters are discussed. [ABSTRACT FROM AUTHOR]

COVID-19 related health disparities are prevalent among higher risk populations like the Hispanic community. Vaccination is one readily available public health tool, yet vaccine uptake is lower among minority populations and hesitations and concerns are high. In the present study, interpersonal and media sources of information about COVID-19 were discussed in a series of six focus groups with Spanish-language dominant and bilingual English-Spanish respondents in a large metropolitan area in Texas. Participants reported using legacy media as a main source of information about COVID-19 vaccines and encountered conspiracy theories and misinformation on social media. Using the Health Belief Model as the theoretical lens, we found individuals' and family members' perceived susceptibility to COVID-19 played a part in participants wanting to find and get the vaccine. Provider recommendations may have served as cues to action. Ease of receiving the vaccines at church and pharmacies may have served to boost participants self-efficacy. Perceived barriers include vaccine specific reasons such as the fast pace of initial authorization, side effects, and long-term effects along with conspiracy theories. Prevailing information gaps regarding the COVID-19 vaccines and the resulting uncertainty are discussed. Understanding information sources and the trust Hispanic communities place in these sources is important in designing effective health messages. [ABSTRACT FROM AUTHOR]

One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections (STIs) affect millions of people annually, costing $16 billion in direct costs each year. Young adults often avoid communicating with their romantic partners about STIs for fear of stigma, thereby limiting their own and their partners' ability to make informed and accurate health decisions. Using Communication Privacy Management theory as the theoretical framework, this study investigates how young adults in romantic relationships communicate about STIs with their partner. Findings show that participants report having conversations about STIs, but do not engage in regular STI testing, thereby limiting their ability to provide accurate information. They also discuss STIs in general rather than the communicating about their own history with STIs, being tested for STIs, or discussing STI test results with their partners. Practical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Our study aimed to estimate how a pediatric patient's health condition status influences parents' perceptions of patient- and family-centered care (PFCC). We analyzed five years (2013–2017) of Medical Expenditure Panel Survey data in efforts to expand understanding of the family influence in pediatric health encounters, using family systems theory as our theoretical lens. The sample included 36,675 parents of children with developmental or chronic health conditions who reported visiting a health-care provider within the past 12 months. The independent variable was a combined measure of any developmental or chronic health conditions previously diagnosed in the child being assessed. Dependent variables included parent reports of communication variables related to how often providers: listened; showed respect; spent enough time; and explained things well. Multivariable logistic regression was used to evaluate the odds of receiving PFCC using a dichotomous measure of PFCC quality and separate domains. Results found that 1) the dichotomous variable of PFCC showed that parents of children with health conditions were less likely to report their provider always performed all elements of PFCC compared to parents whose children did not have any health conditions; 2) parents of children with developmental or chronic health conditions were less likely to report their provider always explained things well compared to parents whose children did not have any health conditions. Efforts to improve PFCC should focus on training providers to demonstrate high-quality practices to improve health outcomes for pediatric patients with developmental or chronic conditions. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic is correlated with decreased physical activity (PA). Transitioning to remote work may impact people's acceptability and preferences for remotely delivered behavioral interventions, including PA. The objective was to examine perceptions of COVID-19 impacts on PA engagement and motivation, and perspectives related to remotely delivered PA interventions. Design: Cross-sectional small-group interview. Setting: Harris County, Texas. Participants: Insufficiently active, overweight/obese adults (16 healthy adults [aged 25–52 years], and 7 cancer survivors [aged 50–74 years]). Method: Group discussion was guided by semi-structured questions. Audio-transcribed data (278 pages) was analyzed using Braun and Clarke's process centering identification, analysis, organization, description, and reports. Results: Overall, participants expressed a decreased level of PA due to the pandemic. Difficulties (e.g., care-taking activities, working from home, and safety concerns) negatively affected motivation. Participants indicated high acceptability of remotely delivered PA interventions, with advantages of virtual technology features (e.g., did not have to maintain a gym membership) and even accountability in maintaining a PA routine (e.g., using virtual groups to engage in community support). Conclusion: Participants described COVID-19 negatively affects access to PA opportunities yet also expressed willingness to engage in remotely delivered PA interventions instead of in-person programs because of their COVID-19 experiences. Remote interventions can greatly increase accessibility and offer opportunities to provide personalized motivation and accountability that people need to be more physically active. [ABSTRACT FROM AUTHOR]

Researcher reflexivity is not a new concept in qualitative research. However, how/if researchers engage in that reflexivity varies. In this essay, the authors engage in reflexivity about a research project they conducted together. The previous project consisted of semi-structured interviews with U.S.-based mothers regarding their perceptions about motherhood. We then used intensive motherhood as a theoretical lens through which we analyzed the interviews. The project also encompassed mothers' perceptions during the COVID-19 global pandemic. Through duoethnography, the researchers reflexively consider major dead angles of their project, challenges they faced, and what reflexivity brings to the forefront. They further reflect on their own communication processes throughout the research project and discuss implications for future researchers. As a result, the authors call for researchers to consider their own positionalities and the effects on research more deeply through collaboration and continual reevaluation. [ABSTRACT FROM AUTHOR]

Alcohol usage among young adults remains a prominent public health concern. Communicating with family members about alcohol can positively influence young adults' perceptions of social norms, yet the stigmatized nature of alcohol-related conversations in the family create a barrier to occurrence of these conversations. This study examines how young adults' familial communication patterns relate to their descriptive and injunctive social norms about limiting alcohol, using Communication Privacy Management Theory as the theoretical framework. Specifically, this study seeks to understand how conversation orientation, conformity orientation, warm conformity orientation, and cold conformity orientation associates with two sets of social norms (descriptive and injunctive), and to investigate how implicit privacy rules mediates each of these relationships. The current study examines 444 college students' responses to several quantitative measures. Implicit privacy rules did fully mediate the relationships between conversation orientation and injunctive social norms about limiting alcohol as well as warm conformity orientation and injunctive social norms about limiting alcohol. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections (STIs) are among the most common infectious diseases in the United States with nearly 20 million new cases diagnosed each year in young adults (age 15–24). Communicating with romantic partners about STIs can positively influence health outcomes, as treatment can then be sought, yet the discussions themselves can pose several face risks to both the person requesting STI information from a partner and the receiver of that request. This study examines how young adults enact and manage facework strategies in STI-related conversations with romantic partners, using Politeness Theory and Communication Privacy Management Theory as theoretical frameworks. Specifically, this study seeks to understand how self-efficacy in conversations about STIs, intentions to talk about STIs and willingness to communicate about health in general predicts four face response strategies (avoid, communicate with partner/talk, defend self, consider other), and to investigate how boundary permeability moderates each of these relationships. We found that boundary permeability affected the relationships between intentions regarding STIs and the communicate with partner and consider other face management responses in conversations about STIs. [ABSTRACT FROM AUTHOR]

Telehealth usage for healthcare encounters has increased dramatically due to the coronavirus disease (COVID-19) precautions. As the pandemic health threat subsides, it is important to understand how telehealth encounters are perceived by users. In this study, we explore how patient-centered communication (PCC), and media and organizational factors, influence patients' intentions to use telehealth in the future. An online survey was conducted among 326 adult patients who reported visiting a healthcare provider using telehealth within the past 12 months. Structural equation modeling explored how contextual factors influenced patients' adoption of telehealth. PCC and ease of use indirectly predicted telehealth adoption through enhanced patient satisfaction and sense of care continuity. Sense of security indirectly predicted telehealth adoption via its association with enhanced rating of care quality. The functionality of telehealth technology does not solely determine patients' telehealth adoption. Instead, positive healthcare experiences, facilitated by organizational support, quality media designs, as well as patient-centered communication, are associated with telehealth adoption. Healthcare providers should strategically improve telehealth-related communication processes that can lead to better patient health outcomes. • Telehealth functionality is not solely responsible for telehealth adoption. • Organizational support is associated with telehealth adoption. • Patient-centered communication is associated with telehealth adoption. [ABSTRACT FROM AUTHOR]

Using affection exchange theory, this study proposed a mediating model between attachment style, affectionate communication, and relationship satisfaction. This dyadic model used marital couples to test actor and partner effects. Overall, results supported the predicted model, including several significant indirect effects. Specifically, affection mediated the relationships between anxious attachment for wives and relationship satisfaction for both wives and husbands. Affection also mediated the relationship between anxious attachment for husbands and husband relationship satisfaction. Affection also mediated the relationship between avoidant attachment for wives and wife relationship satisfaction, as well as between avoidant attachment for husbands and husband relationship satisfaction. Additionally, actor and partner effects were found for the relationship beh\'een affectionate communication and relationship satisfaction for both husbands and wives. [ABSTRACT FROM AUTHOR]