Testing of a Model with Latino Patients That Explains the Links Among Patient-Perceived Provider Cultural Sensitivity, Language Preference, and Patient Treatment Adherence

• Published in: Journal of racial and ethnic health disparities 2016-03, Vol.3 (1), p.63-73
• Main Authors: Nielsen, Jessica D. Jones, Wall, Whitney, Tucker, Carolyn M.
• Format: Article
• Language: English
• Subjects: Adherence; Adult; Attitude to Health - ethnology; Cultural Competency; Cultural sensitivity; Empirical Research; Epidemiology; Ethnicity; Female; Health care access; Hispanic Americans; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Humans; Indirect effects; Internal-External Control; Language; Latin American cultural groups; Linguistics; Low income groups; Male; Medicine; Medicine & Public Health; Models, Theoretical; Patient compliance; Patient Compliance - ethnology; Patient satisfaction; Patient Satisfaction - ethnology; Patients; Perceptions; Physician-Patient Relations; Quality of Life Research; Questionnaires; Race; Reproducibility of Results; Sense of control; Sensitivity; Social Inequality; Social Structure; Structural equation modeling; Surveys and Questionnaires; Training; Training needs; Trust
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-015-0114-y

Introduction Disparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers. Purpose The purpose of this study was to examine whether patients’ perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients. Methods Data from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients. Results No significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence. Conclusion These results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.