Monica E. Peek|Angela Odoms?Young|Michael T. Quinn|Rita Gorawara?Bhat|Shannon C. Wilson|Marshall H. Chin
Race and shared decision-making: Perspectives of African-Americans with diabetes
University of Chicago|University of Illinois at Chicago|University of Chicago|University of Chicago|University of Chicago|University of Chicago
shared decisionmaking sdm important component patientcentered healthcare positively associated improved health outcomes eg diabetes hypertension control shared decisionmaking patients physicians engage bidirectional dialogue patients symptoms treatment options select treatment plans address patient preferences existing research shows africanamericans experience sdm less often whites fact may contribute racial disparities diabetes outcomes yet little known reasons racial disparities shared decisionmaking explored patient perceptions race may influence sdm africanamerican patients physicians conducted indepth interviews n 24 five focus groups n 27 among purposeful sample africanamerican diabetes patients aged 21 years urban academic medical center chicago interviewfocus group audiotaped transcribed verbatim imported atlasti software coding conducted iteratively transcription independently coded two research team members although heterogeneity patients perceptions influence race sdm sdm domains informationsharing deliberationphysician recommendations decisionmaking participants identified range racerelated issues may influence sdm participants identified physician biasdiscrimination andor cultural discordance issues may influence physicianrelated sdm behaviors eg less likely share information test results likely domineering africanamerican patients identified mistrust white physicians negative attitudes internalized racism patientrelated issues may influence africanamerican patients sdm behaviors eg less forthcoming physicians health information deference physicians less likely adhere treatment regimens study suggests racerelated patient physicianrelated barriers may serve significant barriers shared decisionmaking africanamerican patients physicians finding innovative ways address communication barriers important area future research