Alexander Jenson1, Debra L Roter2, Harran Mkocha3, Beatriz Munoz4, Sheila West4. 1. Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore MD, United States. Electronic address: Ajenson1@jhmi.edu. 2. The Johns Hopkins Bloomberg School of Public Health, Baltimore MD, United States. 3. Kongwa Trachoma Project, Kongwa Tanzania. 4. Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore MD, United States.
Abstract
OBJECTIVE: Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. METHODS: In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. RESULTS: 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). CONCLUSION: Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. PRACTICE IMPLICATIONS: Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers.
OBJECTIVE: Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. METHODS: In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. RESULTS: 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). CONCLUSION: Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. PRACTICE IMPLICATIONS: Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers.
Authors: Gelila Kidane Goba; Jessica George; Mussie Alemayehu; Fasika Amdeslasie; Ken Divelbess; Gregory Makoul; Raymond H Curry; Mary D Stephenson Journal: J Grad Med Educ Date: 2019-08