Communication and Control: Hearing the Voices of Low-Income African American Adults to Improve Relationships with Healthcare Providers

• Published in: Health communication 2020-11, Vol.35 (13), p.1633-1642
• Main Authors: Stanley, Samantha J., Chatham, Allison P., Trivedi, Neha, Aldoory, Linda
• Format: Article
• Language: English
• Subjects: Adults; African Americans; Clinical outcomes; Communication; Efficacy; Elaboration; Health care; Health disparities; Income; Low income groups; Management methods; Minority & ethnic groups; Underserved populations
• ISSN: 1041-0236; 1532-7027
• DOI: 10.1080/10410236.2019.1654177

Patient-provider relationships can either impede or encourage patient utilization of healthcare services and adherence to treatment. Given the significant health disparities found among low-income African Americans, it is imperative to understand this population's experiences with healthcare providers and how to improve their patient-provider relationships in order to increase successful treatment outcomes. Relationship management is a well-tested theory that examines factors that improve outcomes between organizations and their publics. This exploratory study uses relationship management theory to understand how African Americans who are medically underserved perceive the quality of their relationships with healthcare providers. Focus groups were held with low-income African American adults. Findings reveal that communication is key to improving trust, but other characteristics needed for a quality relationship were lacking, particularly perceived commitment, which impedes better healthcare. The low-income, medically underserved context influenced participant perceptions of factors such as commitment, but participants also expressed efficacy in feeling in control of healthcare situations, which may help them maintain quality relationships. This study offers theoretical elaboration as well as practical suggestions for how providers may wish to address an important population of patients through communication.