Are Racial Differences in Patient–Physician Cancer Communication and Information Explained by Background, Predisposing, and Enabling Factors?

Abstract

Research shows that African Americans tend to have poorer and less informative patient–physician communication than Whites. We analyzed survey data from 248 African American and 244 White cancer patients to examine whether this disadvantage could be explained by race variability on several other variables commonly reported to affect communication. These variables were organized into background, enabling, and predisposing factors, based on the Precede-Proceed Model. Multivariate regressions were used to test whether race differences in communication and information variables persisted after successively controlling for background, enabling, and predisposing factors. African American patients had higher interpersonal communication barriers than Whites, but this difference did not persist after controlling for background factors. African Americans also had higher unmet information needs and were less likely to receive the name of a cancer expert. These differences persisted after controlling for all other factors. Future research should focus on the informational disadvantages of African American patients and how such disadvantages may affect cancer treatment decisions.

This research was supported by a grant from the National Cancer Institute, Bethesda, MD (Grant no. NCI R01CA77525-U). We thank the Illinois State Cancer Registry and the Tumor Boards at 33 participating hospitals for their cooperation with this study. We are grateful to two anonymous reviewers for their generous comments and suggestions.

Notes

(a) These are the variables on which the samples were stratified.

(b) All variables shown as “% yes” were coded 0 = no, 1 = yes.

(c) These variables were excluded from the regression analyses in Tables 2 and 3.

∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

∗p < .05; ∗∗p < .01; ∗∗∗p < .001.

∗p < .05; ∗∗p < .01; ∗∗∗p < .001.