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Abstract
To ensure comprehension, clinicians have been urged to use “teach-backs”—explicitly asking patients to repeat back key points of instruction—with every patient receiving new care management instructions. Yet, it is not known whether certain patient groups are more likely to receive teach-backs than others. This study used results from the patient survey of the Communication Climate Assessment Toolkit to examine patient-reported incidence of teach-back by patient education level, age, language preference, race/ethnicity, and perception of sufficient time with doctors. In a multivariable model, patients had significantly greater odds of reporting a teach-back if they were of African American race/ethnicity, had non-English language preference, less education, increased age, or perceived that they had sufficient time with their doctor. This study concludes that some physicians seem to be directing teach-back efforts at certain patients, including those from demographic groups where lower literacy is more common, potentially leading patients who could benefit from teach-back to be overlooked. In addition, the strong correlation between reporting receiving a teach-back and reporting having enough time with a doctor merits further study.
Acknowledgments
The development of instruments and data collection for C-CAT validation were supported by The California Endowment, and the authors extend special thanks to their program officer, Ignatius Bau, for his support. In addition, the authors thank Eric Hedberg for help with statistical analyses and the Oversight Body of the Ethical Force program (named at http://www.EthicalForce.org) for their unstinting support.
Notes
Note. [R] is the referent group—education and age used incremental increases instead of a referent group. Odds ratios for education are for each additional year of educational attainment. Odds ratios for age are for 10-year intervals of increased age.
*p < .05, **p < .01, ***p < .001.
