The Patient–Provider Relationship: Predictors of black/African American Cancer Patients’ Perceived Quality of Care and Health Outcomes

ABSTRACT

We examined whether the patient–provider relationship (PPR) is associated with Black survivors’ health outcomes and whether this association was mediated by the quality of care. The outcome variables were survivors’ quality of care and health outcome, and the predictor variable was PPR (communication, emotional support, time spent, and survivors’ shared-decision making). A sample of 223 Black cancer survivors (age 63.0 ± 14.0 years) provided evaluable data. The most common cancer types reported by the participants were: gynecologic (32.7%), genitourinary (21.5%), and gastrointestinal cancers (11.2%). After controlling for covariates. A Structural Equation Model (SEM) showed that PPR was significantly associated with both health outcome (p = .015) and quality of care (p = .002). When PPR and quality of care were tested in the mediation model, the direct association between PPR and health outcome was attenuated, and it was no longer significant (b = −0.05, SE = 0.11, p = .65). However, indirectly, there was a strong association between PPR and health outcome through the quality of care (b = 0.22, SE = 0.08, p = .003), indicating full mediation. Providers’ interpersonal relationships had a significant influence on the health of Black survivors, and this influence may be due to the increased positive perception of the quality of care. The implications of these findings for further research are discussed.

Acknowledgments

The authors declare no potential conflicts of interest. This work was supported by NCI grant R25 CA1026185 and UG1 CA189961.