BACKGROUND: Culturally competent care may be associated with clinical outcomes in diabetes management, which requires effective physician-patient collaboration. The recent development and validation of the Consumer Assessment of Healthcare Providers and Systems Cultural Competence tool enables investigation of possible associations. OBJECTIVE: To assess whether 3 aspects of culturally competent care are associated with glycemic, lipid, and blood pressure control among ethnically diverse patients with diabetes. DESIGN: Survey and chart review study of patients recruited from urban safety net clinics in 2 cities. SUBJECTS: A total of 600 patients with type 2 diabetes and a primary care physician. MEASURES: We used multivariate logistic regression to assess the independent relationships between the 3 domains of the Consumer Assessment of Healthcare Providers and Systems Cultural Competence (Doctor Communication-Positive Behaviors, Trust, and Doctor Communication-Health Promotion) and glycemic, lipid, and systolic blood pressure control after adjusting for sociodemographic and clinical factors. RESULTS: In adjusted analysis, high Trust was associated with lower likelihood of poor glycemic control (odds ratio, 0.59; 95% confidence interval, 0.41-0.84) and high Doctor Communication-Health Promotion was associated with a higher likelihood of poor glycemic control (odds ratio, 1.49, 95% CI, 1.02-2.19). None of the 3 aspects of culturally competent care examined were associated with lipid or systolic blood pressure control after adjustment. DISCUSSION: Trust in physician, a core component of culturally competent care, but not doctor communication behavior, was associated with a lower likelihood of poor glycemic control in a safety net population with diabetes. Glycemic control may be more sensitive to patient physician partnership than blood pressure and hyperlipidemia control.
BACKGROUND: Culturally competent care may be associated with clinical outcomes in diabetes management, which requires effective physician-patient collaboration. The recent development and validation of the Consumer Assessment of Healthcare Providers and Systems Cultural Competence tool enables investigation of possible associations. OBJECTIVE: To assess whether 3 aspects of culturally competent care are associated with glycemic, lipid, and blood pressure control among ethnically diverse patients with diabetes. DESIGN: Survey and chart review study of patients recruited from urban safety net clinics in 2 cities. SUBJECTS: A total of 600 patients with type 2 diabetes and a primary care physician. MEASURES: We used multivariate logistic regression to assess the independent relationships between the 3 domains of the Consumer Assessment of Healthcare Providers and Systems Cultural Competence (Doctor Communication-Positive Behaviors, Trust, and Doctor Communication-Health Promotion) and glycemic, lipid, and systolic blood pressure control after adjusting for sociodemographic and clinical factors. RESULTS: In adjusted analysis, high Trust was associated with lower likelihood of poor glycemic control (odds ratio, 0.59; 95% confidence interval, 0.41-0.84) and high Doctor Communication-Health Promotion was associated with a higher likelihood of poor glycemic control (odds ratio, 1.49, 95% CI, 1.02-2.19). None of the 3 aspects of culturally competent care examined were associated with lipid or systolic blood pressure control after adjustment. DISCUSSION: Trust in physician, a core component of culturally competent care, but not doctor communication behavior, was associated with a lower likelihood of poor glycemic control in a safety net population with diabetes. Glycemic control may be more sensitive to patient physician partnership than blood pressure and hyperlipidemia control.
Authors: Lavinia Lin; Katherine B Brown; Brian J Hall; Fan Yu; Jingqi Yang; Jason Wang; Joshua M Schrock; Adams B Bodomo; Ligang Yang; Bin Yang; Eric J Nehl; Joseph D Tucker; Frank Y Wong Journal: Glob Public Health Date: 2015-09-23
Authors: Arshiya A Baig; Amanda Benitez; Cara A Locklin; Amanda Campbell; Cynthia T Schaefer; Loretta J Heuer; Sang Mee Lee; Marla C Solomon; Michael T Quinn; Deborah L Burnet; Marshall H Chin Journal: J Health Care Poor Underserved Date: 2014-05
Authors: Rebekah J Walker; Brittany L Smalls; Jennifer A Campbell; Joni L Strom Williams; Leonard E Egede Journal: Endocrine Date: 2014-02-15 Impact factor: 3.633
Authors: David Tsai; Jaquelin Flores Garcia; Jennifer L Fogel; Choo Phei Wee; Mark W Reid; Jennifer K Raymond Journal: J Diabetes Sci Technol Date: 2021-07-05