Using Effective Provider-Patient Communication to Improve Cancer Screening Among Low Literacy Patients
| Status: | Completed |
|---|---|
| Conditions: | Breast Cancer, Colorectal Cancer, Cervical Cancer, Cervical Cancer, Cancer, Cancer, Cancer, Women's Studies |
| Therapuetic Areas: | Oncology, Reproductive |
| Healthy: | No |
| Age Range: | 40 - 75 |
| Updated: | 3/11/2017 |
| Start Date: | June 2008 |
| End Date: | June 2012 |
What's the purpose of this study? This 4-year study is designed: (1) to teach primary care
physicians how to recognize low health literacy patients and effectively counsel them on
cancer screening using risk communication and shared decision making and (2) to assess the
impact of training on changes in physician communication behavior and changes in low health
literacy patients' cancer screening behaviors. This study proposal is based on the
hypothesis that physician training in cancer screening guidelines, health literacy, and
communication skills will improve provider-patient interactions during encounters dealing
with preventive health maintenance especially cancer screening.
How will the proposed study be implemented? Thirty-two physicians in the New Orleans
metropolitan area will be recruited and randomly assigned to one of two groups. The unit of
randomization will be the health care organization or clinic. The intervention group will
receive training in health literacy, cancer screening, risk communication and shared
decision-making. The control group will not receive communication training until the end of
the study. Physicians in both groups will undergo three clinic visits with standardized
patients (actors trained to portray real patients; mystery shoppers) but they will not be
aware that they are conducting visits with actors. The visits will occur at study enrollment
and at 6 and 12 months. At the end of each clinic visit, the standardized patients will rate
the physicians' communication skills. Each physician assigned to the intervention group will
receive verbal feedback on communication skills from the standardized patients and complete
a web-based tutorial. Physicians in the control group will not have access to the web-based
tutorial until the end of the study.
For each physician, 10-15 patients with limited health literacy will be recruited to the
study. Each patient will rate his/her perceived involvement with care and global
satisfaction with care at study enrollment and annually for three years. Age and
gender-appropriate referral rates for breast, cervical and colorectal cancer screening and
patients' receipt of such screening will be assessed annually for three years. All study
physicians, regardless of group assignment, will receive performance feedback (report cards)
on their cancer screening rates among low health literacy patients in their clinic.
physicians how to recognize low health literacy patients and effectively counsel them on
cancer screening using risk communication and shared decision making and (2) to assess the
impact of training on changes in physician communication behavior and changes in low health
literacy patients' cancer screening behaviors. This study proposal is based on the
hypothesis that physician training in cancer screening guidelines, health literacy, and
communication skills will improve provider-patient interactions during encounters dealing
with preventive health maintenance especially cancer screening.
How will the proposed study be implemented? Thirty-two physicians in the New Orleans
metropolitan area will be recruited and randomly assigned to one of two groups. The unit of
randomization will be the health care organization or clinic. The intervention group will
receive training in health literacy, cancer screening, risk communication and shared
decision-making. The control group will not receive communication training until the end of
the study. Physicians in both groups will undergo three clinic visits with standardized
patients (actors trained to portray real patients; mystery shoppers) but they will not be
aware that they are conducting visits with actors. The visits will occur at study enrollment
and at 6 and 12 months. At the end of each clinic visit, the standardized patients will rate
the physicians' communication skills. Each physician assigned to the intervention group will
receive verbal feedback on communication skills from the standardized patients and complete
a web-based tutorial. Physicians in the control group will not have access to the web-based
tutorial until the end of the study.
For each physician, 10-15 patients with limited health literacy will be recruited to the
study. Each patient will rate his/her perceived involvement with care and global
satisfaction with care at study enrollment and annually for three years. Age and
gender-appropriate referral rates for breast, cervical and colorectal cancer screening and
patients' receipt of such screening will be assessed annually for three years. All study
physicians, regardless of group assignment, will receive performance feedback (report cards)
on their cancer screening rates among low health literacy patients in their clinic.
Inclusion Criteria:
Physician
- Physicians who practice at these clinic sites at least one half day per week are
eligible to participate in this study.
Patient
- Eligible patients include men and women age 40 to 75, individuals enrolled in the
clinic practice for at least one year, and individuals identified as having low or
inadequate health literacy via the Rapid Estimate of Adult Literacy in Medicine.
Exclusion Criteria:
Physician
- Any provider planning to leave before the end of 12 months will be excluded.
Patient
- Patients will be excluded if they plan to change primary care provider or site of
health plan, have resided in the United States for less than five years, or do not
speak English
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