Social and Behavioral Sciences Commons^™

The Association Of Patient-Provider Language Concordance With Healthcare Comprehension Among Latino/As In Oregon, Grace Parra

University Honors Theses

Background: The purpose of this study is to describe the need and preferences among Mexican-origin Latinos in Oregon for language-concordant healthcare providers. We hypothesize that the presence of a language concordant provider is associated with greater health care comprehension.

Methods: This is a cross sectional study in collaboration with the General Consulate of Mexico. We developed a 20-item survey that includes questions about socio-demographics, a validated language-based acculturation scale, and questions regarding language concordant care experience and preferences used in previous studies. We are recruiting at the Mexican Consulate 500 Latino/as ages 18 or older who had a healthcare visit …

A Physician's Most Important Teachers, Rachel Pray

be Still

I hope to never lose sight of the reasons why I became a physician: to make deep, real connections with patients while they may be going through one of the worst or most uncertain time of their lives - offering comfort and expertise to ease their worries - and to assist them in becoming the best, healthiest, happiest versions of themselves. Remembering my "why" has helped me overcome the struggles and trials of medical school, and I will continue to hold it close to me throughout my medical career.

Parent Attitudes Towards Childhood Vaccines After The Onset Of Sars-Cov-2 In The United States, Douglas J. Opel, Anna Furniss, Chuan Zhou, John D. Rice, Heather Spielvogle, Christine Spina, Cathryn Perreira, Jessica Giang, Jeffrey D. Robinson, Multiple Additional Authors

Communication Faculty Publications and Presentations

Objective: To understand the influence of a novel infectious disease epidemic on parent general attitudes about childhood vaccines.

Methods: We conducted a natural experiment utilizing cross-sectional survey data from parents of infants in Washington and Colorado participating in a larger trial that began on September 27, 2019. At enrollment, parents completed the short version of the Parental Attitudes about Childhood Vaccines (PACV-SF), a validated survey scored from 0-4, with higher scores representing more negative attitudes. The exposure variable was onset of the SARS-CoV-2 pandemic in the US, with the before-period defined as September 27, 2019 –– February 28, …

Smoking Behaviors In Patients Offered Lung Cancer Screening, Sara Elizabeth Golden

Dissertations and Theses

In the United States, smoking causes preventable diseases, including lung cancer, which is the leading cause of cancer deaths. Improving smoking cessation rates is important to decrease lung cancer deaths. Health care visits with a discussion about lung cancer screening (LCS) may help in increasing prevalence of smoking cessation. Importantly, insurers now require clinicians to have a shared decision-making discussion with patients that includes discussion of smoking abstinence before they can receive an LCS scan (i.e., a low-dose computed tomography scan). This discussion may represent a unique opportunity to encourage smoking cessation since it may prompt positive smoking behavior change. …

Frequency Of Limited English Proficient (Lep) Patient Visits And Language Resources: An Assessment Of Rural Oregon's Health Centers And Working With Lep Communities, Gabriel I. Lehrburger

University Honors Theses

Persons with limited English proficiency (LEP) can face barriers when seeking health care. Rural communities often have reduced access to some health resources. However, little is known about how rural communities meet the language needs of their LEP populations. A cross-sectional survey and interview were designed and sent to managerial staff in rural health centers around the state of Oregon. During the months of January – March 2020, survey and interview data were collected to assess the relationship between frequency of LEP patient visits and available language resources in rural Oregon. The study also investigated staff perceptions when working with …

Redemption Or Contamination: Reviewing The Illness Narratives Of The Chronically Sick And Their Support Systems, Allison R. Dearing

Honors Theses

Chronically sick individuals deal with pain on a daily basis, which can lower their quality of life and make it more difficult. Illness narratives or “sickness stories” have been known to help people place illness in their lives. Support systems are a factor that could influence individuals’ illness narratives to lead them towards a redemption or contamination sequence. In this study, I interviewed twenty-five women with endometriosis and asked them questions regarding their health status, illness narratives, and support systems. The interviews were reviewed and categorized between redemptive and contamination sequences.The support systems influence on the sequence were also reviewed …

Impact Of The Childhood Vaccine Discussion Format Over Time On Immunization Status, Douglas J. Opel, Chuan Zhou, Jeffrey D. Robinson, Nora Henrikson, Katherine Lepere, Rita Mangione-Smith, James A. Taylor

Communication Faculty Publications and Presentations

Objective: Presumptive formats to initiate childhood vaccine discussions (e.g. “Well we have to do some shots.”) have been associated with increased vaccine acceptance after one visit compared to participatory formats (e.g. “How do you feel about vaccines?”). We characterize discussion format patterns over time and the impact of their repeated use on vaccine acceptance.

Methods: We conducted a longitudinal prospective cohort study of children of vaccine-hesitant parents enrolled in a Seattle-based integrated health system. After the child’s 2, 4, and 6 month visits, parents reported the format their child’s provider used to begin the vaccine discussion (presumptive, participatory, or …

Clinician-Parent Discussions About Influenza Vaccination Of Children And Their Association With Vaccine Acceptance, Annika M. Hofstetter, Jeffrey D. Robinson, Katherine Lepere, Morgan Cunningham, Nicole Etsekson, Douglas J. Opel

Communication Faculty Publications and Presentations

Objective: To examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making.

Study Design: We performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011-2012 and 2013-2014 influenza seasons, included children ≥ 6 months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance …

Each Medium Tells A Different Story: The Effect Of Message Channel On Narrative Persuasion, Nathan Walter, Sheila T. Murphy, Lauren B. Frank, Lourdes Baezconde-Garbanati

Communication Faculty Publications and Presentations

Limited attention has been given to the medium of story presentation in this process of narrative persuasion. The present study (N = 243) fills this gap by directly comparing narrative involvement across print and audiovisual versions of the same cervical cancer-related story. The mediation analysis revealed that exposure to an audiovisual narrative was associated with higher levels of cognitive and emotional involvement than exposure to the exact same narrative in its printed form. Yet the higher levels of transportation in the audiovisual condition came at a price of enhancing psychological reactance, eliminating the relative advantage of the film narrative.

Information Scanning And Vaccine Safety Concerns Among African American, Mexican American, And Non-Hispanic White Women, Meghan Bridgid Moran, Lauren B. Frank, Joyee S. Chatterjee, Sheila T. Murphy, Lourdes Baezconde-Garbanati

Communication Faculty Publications and Presentations

Objective: A significant number of parents delay or refuse vaccinating their children. Incidental exposure to vaccine information (i.e., scanned information) may be an important contributor to anti-vaccine sentiment. This study examines the association between scanned information, trust in health information sources and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women.

Methods: Women (N=761) in Los Angeles County were sampled via random digit dial and surveyed regarding use of and trust in health information resources and vaccine safety concerns.

Results: Analyses indicate that the sources of information associated with vaccine safety concerns varied by …

Mistrust: An Exploration Of African Americans' Attitudes And Perspectives Toward Healthcare, Adolfo Gabriel Cuevas

Dissertations and Theses

This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. …

The Ability Of Narrative Communication To Address Health-Related Social Norms, Meghan B. Moran, Sheila T. Murphy, Lauren B. Frank, Lourdes Baezconde-Garbanati

Communication Faculty Publications and Presentations

Social norms are an important predictor of health behavior and have been targeted by a variety of health communication campaigns. However, these campaigns often encounter challenges related to the socially specific context in which norms exist: specifically, the extent to which the target population identifies with the specific reference group depicted and the extent to which the target population believes the campaign’s message. We argue that because of its capacity to effect identification among viewers, narrative communication is particularly appropriate for impacting social norms and, consequently, behavioral intention. This manuscript presents the results of a randomized trial testing the effectiveness …

Intraprofessional Nursing Communication And Collaboration: Apn-Rn-Patient Bedside Rounding, Rita M. Herm-Barabasz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Executive Summary

Leading advisory agencies have long advocated that health care must be safe and effective (Institute of Medicine [IOM], 2001). In order for health care to be safe and effective, good communication and collaboration are essential. Research has found that in health care, poor communication and teamwork failures are the major contributors to adverse events (Cornell, Townsend-Gervis, Vardaman, & Yates, 2014; The Joint Commission, 2011; O’Leary, 2012). Such communication-related adverse events can cause avoidable injury, loss of life, and financial devastation. In light of advanced practice nurses’ (APN) increasing contribution in care management, and in order to ensure delivery …

The Lived Experiences Of Acute-Care Bedside Registered Nurses Caring For Patients And Their Families With Limited English Proficiency, Jami-Sue Coleman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals …

Patients’ Perception Of Patient–Provider Communication In Fertility Preservation Decision Making Among Young Women With Cancer, Aakrati Mathur, E. Roberto Orellana, Amy Frohnmayer, Pauline Jivanjee, Lillian Nail, Brandon Hayes-Lattin, Rebecca G. Block

School of Social Work Faculty Publications and Presentations

Fertility preservation (FP) for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to …

Coping With Pediatric Cancer: Conversational Methods Utilized By Parents And Children When Dealing With Pediatric Cancer, Chelsi Morgan Walls

Graduate Research Symposium (GCUA) (2010 - 2017)

This thesis sought to analyze how parents communicate with their child regarding pediatric cancer treatments. When dealing with pediatric cancer, it is vital that parents and their child communicate about the illness in order to effectively cope with the cancer. Using Uncertainty Management Theory, along with sub-concepts of the theory (i.e., appraisals, inferences, and illusions), this thesis sought to discover which coping mechanism (i.e., affect-management or buffering) would be chosen to manage the illness. Under UMT, appraisals were assessed, resulting in positive and negative appraisal, which indicated whether the individual handled the issue with either an inference based on general …

International And Domestic Student Health-Information Seeking And Satisfaction, Stacy Theodora Austin

Dissertations and Theses

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking …

Narrative Versus Nonnarrative: The Role Of Identification, Transportation And Emotion In Reducing Health Disparities, Sheila T. Murphy, Lauren B. Frank, Joyee S. Chatterjee, Lourdes Baezconde-Garbanati

Communication Faculty Publications and Presentations

This research empirically tests whether using a fictional narrative produces a greater impact on health-related knowledge, attitudes, and behavioral intention than presenting the identical information in a more traditional, nonfiction, non-narrative format. European American, Mexican American, and African American women (N = 758) were surveyed before and after viewing either a narrative or non-narrative cervical cancer-related film. The narrative was more effective in increasing cervical cancer-related knowledge and attitudes. Moreover, in response to the narrative featuring Latinas, Mexican Americans were most transported, identified most with the characters, and experienced the strongest emotions. Regressions revealed that transportation, identification with specific characters, …

The Influence Of Patient-Centeredness On Minority And Socioeconomically-Disadvantaged Patients’ Trust In Their Physicians: An Evidence-Based Structural Equation Modeling Investigation, Stephen J. Aragon, Sylvia A. Flack, Cecil A. Holland, Racquel R. Ingram, Michael L. Clements

Journal of Health Disparities Research and Practice

The purpose of this investigation was to determine the effect of physician patient-centeredness on patient trust across randomly selected groups of patients from an inner city medical practice serving a preponderance of minority and socioeconomically-disadvantaged patients.

METHODS: A two-factor multigroup structural equation modeling design was employed, with randomly selected test (N = 300) and cross-validation (N = 300) samples of medical practice patients. Equality constraints were established to test the invariance of effects across groups. The model was compared to its unconstrained counterpart to further test its trustworthiness. An additional 5,000 nonparametric bootstrapped samples for each group were generated to …

Health Literacy As A Contributor To Immigrant Health Disparities, Jennifer B. Kimbrough

Journal of Health Disparities Research and Practice

The ability to obtain, understand and use the information needed to make wise health choices is known as health literacy. Low health literacy among members of populations with poor reading skills, limited mastery of the English language, members of ethnic or cultural minorities, and immigrants is likely a major contributor to health disparities in the US (Agency for Health Care Policy and Research 1997). A series of focus groups with East-Asian, African, Central and South American immigrants was conducted to better understand the perceptions of immigrants seeking health care services in an urban North Carolina county. Participants’ responses are reported …

Narrative Based Fear Appeals Manipulating Grammatical Person And Message Frame To Promote Hpv Awareness And Responsible Sexual Conduct, Jennifer Akeley Spear

Electronic Theses and Dissertations

The utility of narrative as a persuasive mechanism has been increasingly investigated in recent years especially within the context of health behaviors. Although many studies have noted the effectiveness of narrative-based persuasive appeals, conceptual inconsistencies have made it difficult to determine what specific aspects of narrative messages lead to the most effective persuasive outcomes. In the present study, 145 female college students were randomly assigned to read one of four narrative health messages about a female freshman college students experiences with the human papillomavirus (HPV). Two elements of the narrative message structure were manipulated: the message frame (gain framed vs. …

Assessing The Impact Of Culture And Language Barriers Among Latino/A Bone Marrow Transplant Patients And Their Parent (S) : A Descriptive Study : A Project Based Upon An Investigation At Childrens Hospital Los Angeles, Los Angeles, California, Lorena Mocorro

Theses, Dissertations, and Projects

This study examined correlations and the impact between culture, language barriers, medical adherence, post transplant recovery and quality of life among monolingual Spanish or bilingual English and Spanish female and male pediatric Latino/Hispanic transplant recipients between the ages of 13 to 21 who have undergone either an autologous or allogeneic blood stem cell (bone marrow) transplant and their parent(s)/caretakers. By definition, bone marrow transplant is the treatment of hematopoietic stem cell from bone marrow, cord blood or peripheral blood. An allogeneic bone marrow transplant is the infusion of healthy blood stem cells from a related or unrelated person, called a …

Physician-Patient Communication About Patients' Sexual Activities And Substance Use : Information Exchange On Potentially Delicate Matters, Paul Michael Denvir

Legacy Theses & Dissertations (2009 - 2024)

Previous interaction-based research has shown that physicians and patients collaboratively realize the routine character of comprehensive medical histories through their communicative behavior. A primary resource in this regard is the design of information seeking and reporting actions. Physicians seek information through closed-ended query formats and patients report information in fitted, minimal formats. This organization provides a relatively efficient way to address a wide range of health-related topics. One topical domain that has been described as sensitive and difficult is patient `lifestyle,' which typically includes discussion of sexual activities and substance use. In these domains, patients engage in some special interactional …

The Relationship Of Patients' Perceptions Of Physicians' Communication Style To Patient Satisfaction, Lisa Diane Abramson

Dissertations and Theses

This thesis examines the relationship between physician communication style and patient satisfaction in the diagnostic medical interview. Patient satisfaction is a critical issue for health care organizations today. Health care organizations are coping with the recruitment and maintenance of patient consumers in a competitive and costly market.

The literature indicates that effective communication between the physician and the patient is important to patient satisfaction. The physician needs to structure the medical visit in order to acquire medical information and, at the same time, invite communication with patients to determine their concerns and needs. Patient satisfaction may ensue if the patient …

The Communication Of Wellness Concepts Interculturally In An Alaskan Health-Care Context, Janet A. Allan

Dissertations and Theses

The purpose of this study is to investigate in what ways cultural value differences between Alaskan Native clients and non-Native health professionals affect the communicating of "wellness" concepts. Specifically, this study focuses on possible difference in the cultural value orientation of "Man's Relationship to Health."

Satisfaction And Quality : Patient Perspectives In Medical Care, Marguerite L. Foeller

Dissertations and Theses

Patient dissatisfaction with the physician/patient relationship and medical care is well documented in both the lay press and the medical literature. This problem appears to stem from communication between physician and patient and is drawing increased attention from the communication discipline. Research conducted in interpersonal communication satisfaction theory provides a basis for this study of patient satisfaction with physician/patient communication and its relationship to the perceived quality of medical care.

This paper reports two sets of interviews with a total of 108 respondents on the topic of physician/patient communication which resulted in the identification of nine salient issues which appeared …

Children With Porencephaly: A Study Of Services, Dana Kaufman, Elisabeth Mason

Dissertations and Theses

This study was conducted to serve as a follow-up of services received and/or needed by families with children who have been identified by Crippled Children's Division of the University of Oregon Health Sciences Center as having porencephaly, usually a severe form of brain damage. Porencephaly refers to cystic cavities or lesions in the brain caused by a prenatal insult to the brain resulting in varying degrees of motor and mental deficits. These children have been seen in general as part of the Cerebral Palsy Clinic. There may be a lack of awareness on part of the parents and the staff …