B133 - Patient-provider identity concordance in chronic pain: the role of discrimination
Time: 11:00 AM - 11:50 AMTopics: Pain, Health of Marginalized Populations
Poster Number: B133
Chronic pain (CP) has substantial impact on quality of life. Engaging in healthcare is critical for better CP management, but a significant challenge in promoting engagement is aligning patient-provider identities. Patients with providers who do not share their background are more likely to report low quality of care or to delay or skip healthcare visits, leading to disparities in CP. The importance of patient-provider identity concordance may be dependent upon experiences of discrimination within the healthcare system. To better understand this interpersonal dynamic, we investigated how important aspects of discrimination are in predicting CP patient’s preference for identity concordant providers. Participants (N=13,459) from the All of Us Research Program, a National Institutes of Health database, reported their perceived importance of provider identity concordance, their frequency of delaying or cancelling healthcare visits due to provider identity discordance, and their experiences of discrimination in medical settings (DMS). We used AIC model selection to distinguish among a set of possible models describing the relationship between seven items from the DMS survey and patient-provider identity concordance items. We leveraged a multi-model inference to determine which discrimination item was most important in predicting patient-provider identity concordance items. The best model for predicting importance of provider identity concordance (wAICc =0.2) included being treated with less respect (w = .91), feeling unheard (w = .87), being treated with less courtesy (w = .76), and a provider acting afraid of the patient (w = .75). The best model for predicting frequency of delaying or cancelling an appointment because of provider racial discordance (wAIC= .26) included a provider acting as if they don’t think the patient is smart (w = .99), being treated with less respected (w = .93), not being heard (w = .88), and providers acting as if they are better than the patient (w = .87). These results suggest which aspects of discrimination are most important to consider in predicting a CP patient’s preference for identity concordant providers. These findings emphasize the need for diverse healthcare providers and highlight target areas in healthcare provider trainings. Future research opportunities include healthcare experiences and preferences within specific minoritized communities to mitigate disparities in CP care.
Keywords: Pain, Health disparitiesAuthors and Affliiates
Presenter: Maya Joshi Delity, University of Colorado DenverCo-Author: Alexandra M. Otto, University of Colorado Denver
Co-Author: Daniel Luedtke, MA, MA, University of Colorado Denver
Co-Author: Amy B. Wachholtz, PhD, MDiv, MS, FSBM, PhD, MDiv, MS, FSBM, University of Colorado Denver
B133 - Patient-provider identity concordance in chronic pain: the role of discrimination
Category
Scientific > Poster/Paper/Live Research Spotlight