Ralph K. White|Rosette J. Chakkalakal|Caroline A. Presley|Aihua Bian|Jonathan S. Schildcrout|Kenneth A. Wallston|Shari Barto|Sunil Kripalani|Russell L. Rothman
Perceptions of Provider Communication Among Vulnerable Patients With Diabetes: Influences of Medical Mistrust and Health Literacy
Mayo Clinic in Florida|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center
patientprovider communication modifiable linked diabetes outcomes association communication quality medical mistrust unknown examined factors within context lowliteracynumeracyfocused intervention improve diabetes care using baseline data diverse patients enrolled randomized trial health communication intervention demographics measures health communication communication assessment tool cat interpersonal processes care survey ipc18 health literacy short test functional health literacy adults depression medical mistrust glycemic control ascertained adjusted proportional odds models used test association mistrust patientreported communication quality interaction effect health literacy mistrust communication quality also assessed total 410 patients analyzed high levels mistrust observed multivariable modeling patients higher mistrust lower adjusted odds reporting higher cat score adjusted odds ratio aor 067 95 confidence interval ci 052 086 p 003 higher scores communication aor 069 95 ci 055 088 p 008 decided together aor 074 95 ci 059 093 p 02 interpersonal style aor 069 95 ci 053 090 p 015 subscales ipc18 observed evidence interaction effect health literacy association mistrust decided together subscale ipc18 patients higher mistrust lower literacy perceived worse communication relative mistrustful patients higher literacy conclusion medical mistrust associated poorer communication providers public health setting patients health literacy level may vary effect mistrust interactional aspects communication providers consider impact mistrust communication vulnerable diabetes populations focus efforts mitigating influence