期刊
PATIENT EDUCATION AND COUNSELING
卷 98, 期 11, 页码 1360-1366出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2015.06.011
关键词
Complementary health approaches; Integrative medicine; Complementary and alternative medicine; Diabetes; Health communication; Limited English proficiency; Health disparities; Disclosure
资金
- Agency for Healthcare Research and Quality [R18HS017261, R03HS020684]
- Centers for Disease Control and Prevention [5U58DP002007-03]
- Health Delivery Systems Center for Diabetes Translational Research (CDTR) through the National Institute of Diabetes and Digestive and Kidney Diseases grant [1P30-DK092924]
- UCSF Collaborative Research Network funded through NIH [UL1 RR024131]
- National Center for Complementary and Integrative Health [K01AT006545]
- National Center for Advancing Translational Sciences [KL2TR00143]
Objective: Patient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociod-emographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes. Methods: We used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n = 278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication. Results: Among racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n = 133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR = 2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR = 1.50, 95% CI: 1.03, 2.19), shared decision making (AOR = 1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR = 1.46, 95% CI: 1.03, 2.09). Conclusion: Safety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication. Practice implications: Patient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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