MEASURING INTERPERSONAL PROCESSES IN DIVERSE PATIENTS

描述：（来自摘要）。有大量的证据表明贫困

DESCRIPTION: (from the abstract). There is substantial evidence of poorer health for persons with lower socioeconomic status or from minority groups than for their counterparts. Little attention has been paid to the role of the quality of medical care, although technical care is known to be poorer for some racial/ethnic groups. One emerging hypothesis for these health and technical care disparities is differences in interpersonal processes of care that occur between patients and clinicians. In preliminary work, this team developed and empirically tested a multidimensional conceptual framework of interpersonal processes that incorporated views of ethnically and socioeconomically diverse groups. The framework was generally confirmed by a survey instrument measuring each of the concepts, but more work is needed to assure comparability of measures. This project aims to finalize the framework and self-report survey of interpersonal processes to be conceptually and psychometrically adequate for African American, Latino, and white patients. The main propose of the instrument is to enable examination of interpersonal processes as a mechanism by which to explain health and technical care disparities. Subjects are patients aged 18 and older from a large multispecialty group practice setting in Northern California serving racially, ethnically, and socioeconomically diverse patients. The specific aims of this cross-sectional study are to: 1. refine the interpersonal processes framework and instrument based on new qualitative studies (focus groups, cognitive testing) and data from the 1st generation study in the 3 racial/ethnic groups, and 2. field test the refined instrument in patients from 3 groups (N=1,200, 400 per group) and evaluate the psychometric properties and validity of the hypothesized measures using structural equation modeling to assure that the final measures have similar measurement properties and validity across the 3 groups. The resulting instrument can be used to examine how interpersonal processes are related to technical processes and clinical outcomes. Interventions arising from such studies could contribute to quality improvements in caring for diverse groups.