Investigating the role of physician communication behaviors on the use of telehealth visits by older Black Americans with chronic conditions

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-09-05 DOI:10.1016/j.pec.2025.109334

Carolyn M. Tucker , Guillermo M. Wippold , Stephen Anton , Kirsten Klein , Ji-Hyun Lee , Derek Li , Duane Mitchell , Ann-Marie Knight , Eric B. Stewart , Kaylyn A. Garcia

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引用次数: 0

Abstract

Background

Older Black Americans experience barriers to healthcare, including patient-provider communication challenges that often deter uptake of telehealth services. This study investigated the effects of varying verbal and nonverbal communication on study participants’ (a) likelihood of using telehealth, and (b) likelihood of having a telehealth visit with the physician.

Methods

Inclusion criteria were: (a) self-identified as Black, (b) age 55 years or older, (c) had obesity, and at least one other metabolic risk factor, and (d) had not used in-person health care or telehealth in the past three years. Participants were randomized to one of three groups, and each of these groups watched one of three videos in which a White male physician explained telehealth services to an older Black man using (1) direct, yet professional communication style characteristic of a typical clinical encounter, (2) verbal communication style aligned with patient-centered care, yet nonverbal behaviors misaligned with patient-centered care, or (3) microaggressive communication. Pre- and post- measures were collected.

Results

110 (mean age = 66.6) older Black adults participated. Participants who viewed the direct, yet professional communication video reported a significantly higher likelihood of using telehealth services following the video. No such significant change occurred in participants who viewed the other two videos. Those who watched the direct, yet professional or verbally patient-centered communication video reported a significantly higher likelihood of having a telehealth appointment with the physician in the video compared to those who watched the microaggressive video.

Conclusions

This study found that older Black adults are more likely to use telehealth services when physicians communicate in a manner that is straightforward and includes direct messaging. Additionally, misaligned verbal and nonverbal behaviors may undermine a patient-centered communication style. Practice Implications This understanding may promote future use of telehealth services among the high risk population of older Black adults.

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调查医生沟通行为在美国老年黑人慢性病患者远程医疗访问中的作用

年龄较大的美国黑人在医疗保健方面遇到障碍，包括患者与提供者之间的沟通挑战，这些挑战往往阻碍了他们接受远程医疗服务。本研究调查了不同的语言和非语言沟通对研究参与者(a)使用远程医疗的可能性和(b)与医生进行远程医疗访问的可能性的影响。方法纳入标准为：(a)自我认定为黑人，(b)年龄在55岁或以上，(c)肥胖，并且至少有一种其他代谢危险因素，(d)在过去三年内没有使用过面对面的医疗保健或远程医疗。参与者被随机分为三组，每组观看三段视频中的一段，视频中一位白人男性医生向一位年长的黑人男性解释远程医疗服务，视频使用的方式有：(1)典型临床遭遇的直接而专业的沟通方式；(2)与以患者为中心的沟通方式一致的语言沟通方式；(3)与以患者为中心的沟通方式不一致的非语言行为；收集了前后测量数据。结果110名黑人老年人（平均年龄66.6岁）参加了调查。观看了直接而专业的通信视频的参与者报告说，观看视频后使用远程保健服务的可能性要高得多。在观看了另外两个视频的参与者身上，没有出现这种显著的变化。那些观看直接的、专业的或以病人为中心的口头交流视频的人报告说，与那些观看微攻击性视频的人相比，他们与视频中的医生进行远程医疗预约的可能性要高得多。这项研究发现，当医生以一种直截了当的方式进行沟通时，老年黑人更有可能使用远程医疗服务，包括直接信息。此外，不一致的语言和非语言行为可能会破坏以患者为中心的沟通方式。实践意义这一认识可能促进未来在老年黑人成人的高风险人群中使用远程医疗服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.