Teaching patients to communicate with physicians: the impact of race

Research on physician-patient communication has focused on the effect of physician communication training on health care outcomes. Much less is known about patient communication training, and even less about the impact of patient race on the effectiveness of patient communication interventions. One hundred and fifty patients of 25 family physicians were randomly assigned to one of three groups: 14-page patient communication workbook received 2-3 days pre-visit, 2-page patient communication handout received in the waiting room, or control group. Racial differences in the impact of patient communication training communication variables, immediate and delayed recall of information, and adherence to treatment were analyzed by t-test and ANOVA techniques. Across analyses, workbook communication skills training had a strong and significant effect on white patients but minimal or no effect on African-American patients. Minimal differences in dependent variables between racial groups existed for the patient handout and control groups. A partial correlation analysis was conducted to factor out the variance due to education. Results suggested that patient race accounted for the results over and above differences in education between racial groups. Our results suggested that the benefits of communication training can be enhanced by taking into account patient characteristics such as race and culture.