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

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.