1. Disclosure of complementary health approaches among low income and racially diverse safety net patients with diabetes
- Author
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Chao, MT, Handley, MA, Quan, J, Sarkar, U, Ratanawongsa, N, and Schillinger, D
- Subjects
Male ,Disclosure ,Medical and Health Sciences ,7.3 Management and decision making ,Complementary health approaches ,Clinical Research ,Diabetes Mellitus ,Humans ,Integrative medicine ,Poverty ,Limited English proficiency ,Metabolic and endocrine ,Physician-Patient Relations ,Medical Assistance ,Continental Population Groups ,Racial Groups ,Diabetes ,Psychology and Cognitive Sciences ,Middle Aged ,Health Services ,Good Health and Well Being ,Complementary and alternative medicine ,Health communication ,Female ,Management of diseases and conditions ,Public Health ,Health disparities ,Delivery of Health Care - Abstract
ObjectivePatient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes.MethodsWe 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.ResultsAmong 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).ConclusionSafety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication.Practice implicationsPatient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches.
- Published
- 2015