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David W. Baker, MD, MPH1, Kenzie A. Cameron, PhD2, Joe Feinglass, PhD2, Patricia V. Niemeck, BA2, Shawn Foster, BA3, Debbie Pierce, BA3, Jason Thompson, BA2, and Romana Hasnain-Wynia, PhD3. (1) The Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St., Suite 200, Chicago, IL 60611, (2) The Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St., Suite 200, Chicago, IL 60611, (312) 695-1479, k-cameron@northwestern.edu, (3) Health Research and Educational Trust, One North Franklin, 30th Floor, Chicago, IL 60606
BACKGROUND – Many patients feel uncomfortable reporting their race/ethnicity to health care providers. We tested four phrases to determine whether these helped to relieve patients’ concerns. METHODS – We recruited medicine clinic patients following their visit; 81 of 169 (48%) agreed to participate. Participants were asked to rate on a scale from 1 (very uncomfortable) to 10 (very comfortable) how comfortable they would feel if asked to report their race/ethnicity to a clerk in a hospital or clinic. Participants were then read four statements explaining the rationale for collecting this information: 1) “…review the treatment that all patients receive and make sure everyone gets the highest quality of care.” (“Monitoring”); 2) “Several government agencies recommend we collect information… as part of a national effort to make sure all patients have access to quality health care.” (“Government”), 3) “…This will help us decide who to hire, how to train our staff better, and what health information is most helpful for our patients” (“Needs Assessment”), and 4) “…help us make sure you get the best care possible” (“Personal Gain”). We determined how each statement affected patients’ comfort level using a) a five-item Likert scale, and b) by having patients’ rate their comfort level again on the original 1-10 scale. Finally, we asked which of the four statements they preferred. RESULTS- To date, 81 patients have participated (mean age 45, 74% female). A total of 22% said they would be very uncomfortable reporting their race/ethnicity (score < 3), and another 26% were only moderately comfortable (score 4-7). The “Monitoring” statement improved patients’ comfort level the most, with 58% stating they felt somewhat or much more comfortable (versus “Government” 33%, p = 0.002; “Needs Assessment” 42%, p = 0.003; and “Personal Gain” 45%, p = 0.02). Among the 47 patients who were not fully comfortable reporting their race/ethnicity initially (i.e., comfort score < 10), the change in comfort rating on the 1-10 scale also increased the most with the “Monitoring” statement (mean scores 1.3 compared to 0.12, 0.21, and 0.51 for statements 2-4, respectively; p = 0.004, p = 0.02, and p = 0.06 in pairwise comparisons to the “Monitoring” statement). The “Monitoring” statement was preferred most frequently (35% versus 6%, 26%, and 21% for statements 2-4). CONCLUSIONS – Providing information to patients about the reasons for recording their race/ethnicity can help ease concerns, although many people remain uncomfortable even after hearing these rationales.
Learning Objectives: At the conclusion of this session, the participant will be able to
Keywords: Health Disparities,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.