Between and within race differences in patient-centeredness and activation in mental health care |
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| Institution: | 1. Veterans Affairs VISN 5 Mental Illness Research, Education, and Clinical Center, Baltimore, USA;2. School of Social Work, University of Maryland-Baltimore, Baltimore, USA;3. Department of Psychiatry, University of Maryland-Baltimore, Baltimore, USA;4. College of Arts and Sciences, University of Baltimore, Baltimore, USA;1. The International Federation of Kidney Foundation – World Kidney Alliance (IFKF-WKA), Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine, Orange, CA, USA;2. Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong;3. Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA;4. Tanker Foundation, Chennai, India;5. Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;6. Hong Kong Kidney Foundation and the International Federation of Kidney Foundations – World Kidney Alliance, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China;7. Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria;8. James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA;9. Italian Kidney Foundation, Rome, Italy;10. World Kidney Day Office, Brussels, Belgium;11. Polycystic Kidney Disease Charity, London, UK;12. American Association of Kidney Patients. Tampa, FL, USA;13. Hong Kong Kideny Foundation, Hong Kong, China;14. Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt;15. Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;1. Department of Family Medicine, American University of Beirut, Lebanon;2. Division of Orthopedic Surgery / Department of Surgery, American University of Beirut, Lebanon;3. Department of Arts and Science, American University of Beirut, Lebanon;1. Cleveland Clinic Center for Value-Based Care Research, 9500 Euclid Ave, G10, Cleveland, OH 44195, USA;2. Cleveland Clinic, Family Medicine, 26900 Cedar Rd, Beachwood, OH 44122, USA;1. Azienda USL-IRCCS di Reggio Emilia, Italy;2. University of Hull, Hull, UK;3. University of Parma, Parma, Italy |
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| Abstract: | ObjectivesThe aim of this study was to compare Black and White mental health care patients’ perceptions of their providers’ and their own participation in patient-centered mental health care. Perceptions of patient-centered care (PCC) in relation to the Multidimensional Model of Racial Identity were explored.MethodsBlack and White veterans receiving mental health care (n = 82) completed surveys assessing patient activation, involvement in care, perceptions of PCC, and therapeutic alliance. Black participants (n = 40) also completed the Multidimensional Inventory of Black Identity.ResultsThere were no differences by race in perceived PCC, though Black participants had lower levels of therapeutic alliance with their mental health care provider and were less activated. Black identity centrality, private regard, and public regard were positively related to PCC and elements of PCC such as patient information seeking/sharing.ConclusionsIntragroup identity variables such as racial centrality, regard, and ideology influenced perceived PCC among Black participants. Race identity variables should be explored in future research on racial disparities and PCC.Practice implicationsMental health care providers serving Black patients should create opportunities to discuss racial identity and race-related experiences as part of their efforts to improve therapeutic alliance and increase the patient-centeredness of care. |
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| Keywords: | Patient-centered care Patient activation Mental health care African Americans Black identity |
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