Disclosure of Complementary Health Approaches among Low Income and Racially Diverse Safety Net Patients with Diabetes

Details

• Alternative Title:
  Patient Educ Couns
• Personal Author:
  Chao, MT ; Handley, MA ; Quan, J ; Sarkar, U ; Ratanawongsa, N ; Schillinger, D
• Description:
  Objective
  
  Patient-provider communication about complementary health approaches can support diabetes self-management by minimizing risk and optimizing care. We sought to identify sociodemographic and communication factors associated with disclosure of complementary health approaches to providers by low-income patients with diabetes.
  
  Methods
  
  We used data from San Francisco Health Plan's SMARTSteps Program, a trial of diabetes self-management support for low-income patients (n=278) through multilingual automated telephone support. Interviews collected use and disclosure of complementary health approaches in the prior month, patient-physician language concordance, and quality of communication.
  
  Results
  
  Among racially, linguistically diverse participants, half (47.8%) reported using complementary health practices (n=133), of whom 55.3% disclosed use to providers. Age, sex, race/ethnicity, nativity, education, income, and health literacy were not associated with disclosure. In adjusted analyses, disclosure was associated with language concordance (AOR=2.21, 95% CI: 1.05, 4.67), physicians' interpersonal communication scores (AOR=1.50, 95% CI: 1.03, 2.19), shared decision making (AOR=1.74, 95% CI: 1.33, 2.29), and explanatory-type communication (AOR = 1.46, 95% CI: 1.03, 2.09).
  
  Conclusion
  
  Safety net patients with diabetes commonly use complementary health approaches and disclose to providers with higher patient-rated quality of communication.
  
  Practice Implications
  
  Patient-provider language concordance and patient-centered communication can facilitate disclosure of complementary health approaches.
  
  
• Subjects:
  Article Complementary And Alternative Medicine Complementary Health Approaches Diabetes Disclosure Health Communication Health Disparities Integrative Medicine Limited English Proficiency
• Source:
  Patient Educ Couns. 98(11):1360-1366.
• Pubmed ID:
  26146238
• Pubmed Central ID:
  PMC4609248
• Document Type:
  Journal Article
• Funding:
  P30 DK063720/DK/NIDDK NIH HHS/United States ; KL2 TR000143/TR/NCATS NIH HHS/United States ; K01AT006545/AT/NCCIH NIH HHS/United States ; R03HS020684/HS/AHRQ HHS/United States ; 1P30-DK092924/DK/NIDDK NIH HHS/United States ; K01 AT006545/AT/NCCIH NIH HHS/United States ; P30 DK092924/DK/NIDDK NIH HHS/United States ; R18HS017261/HS/AHRQ HHS/United States ; UL1 RR024131,/RR/NCRR NIH HHS/United States ; KL2TR00143/TR/NCATS NIH HHS/United States ; K08 HS022561/HS/AHRQ HHS/United States ; 5U58DP002007-03/DP/NCCDPHP CDC HHS/United States
• Volume:
  98
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:737ea2fc8d4706bbbe063b8d3cbf691c340ac173cfe3697818bf1678f2fe3c0906601500bf57de258c993cc76dea2f1181316b4f72fb973cbfbcfdd802439d0f
• Download URL:
  https://stacks.cdc.gov/view/cdc/37414/cdc_37414_DS1.pdf
• File Type:
  [PDF - 172.62 KB ]