Black Parent's Perceptions of Discussing Cardiovascular Disease Risk with Primary Care Clinicians: a Qualitative...

Primary care clinicians (PCCs) are tasked with communicating cardiovascular disease (CVD) risk to adults who are parents, including Black individuals. The impact of these discussions with parents is especially important because of the potential translation of lifestyle behaviors to their children. However, sparse research has examined Black parent's preferences on whether and how their PCCs should discuss parent's personal CVD risk and associated lifestyle behaviors. This study aimed to understand Black parent's perception of the role PCCs should play in communicating CVD risk and examined their preferences regarding how to communicate risk.

Qualitative focus groups (n = 10) were conducted with Medicaid-enrolled Black parents who have a school-aged child (6-11 years). Parents were recruited from primary care clinics affiliated with an academic medical center and community organizations in central Ohio. Focus group discussion questions were developed using two theoretical frameworks, including the Health Belief Model, to assess parent's desire and preferred approach to discussing CVD risk with their PCC. Focus groups were analyzed using thematic analysis to determine communication preferences.

Forty-four parents (n = 40 female; median age 32 [range 24- 57] years) participated in the focus group discussions. Six major themes were identified including: 1) The desire to change health behaviors can be triggered by the recognition of risk factors, which can be highlighted by PCCs; 2) PCCs facilitate lifestyle behavior change by working with patients to develop a plan; and 3) Early communication about CVD risk factors is desired and expected, to prevent the onset of CVD. Other themes discussed the importance of the PCC-patient relationship along with facilitators and barriers to change.

Medicaid-enrolled Black parents indicated their desire for PCCs to discuss their personal CVD risk factors with them. This study highlights the importance of patient-provider communication when discussing CVD risk and risk factors.