The Presence 5 for Racial Justice Framework for anti-racist communication with Black patients.

African American Black communication community-based participatory research design thinking human-centered design patient care qualitative

Journal

Health services research
ISSN: 1475-6773
Titre abrégé: Health Serv Res
Pays: United States
ID NLM: 0053006

Informations de publication

Date de publication:
12 2022
Historique:
pubmed: 30 6 2022
medline: 16 11 2022
entrez: 29 6 2022
Statut: ppublish

Résumé

To identify communication practices that clinicians can use to address racism faced by Black patients, build trusting relationships, and empower Black individuals in clinical care. Qualitative data (N = 112 participants, August 2020-March 2021) collected in partnership with clinics primarily serving Black patients in Leeds, AL; Memphis, TN; Oakland, CA; and Rochester, NY. This multi-phased project was informed by human-centered design thinking and community-based participatory research principles. We mapped emergent communication and trust-building strategies to domains from the Presence 5 framework for fostering meaningful connection in clinical care. Interviews and focus group discussions explored anti-racist communication and patient-clinician trust (n = 36 Black patients; n = 40 nonmedical professionals; and n = 24 clinicians of various races and ethnicities). The Presence 5 Virtual National Community Advisory Board guided analysis interpretation. The emergent Presence 5 for Racial Justice (P5RJ) practices include: (1) Prepare with intention by reflecting on identity, bias, and power dynamics; and creating structures to address bias and structural determinants of health; (2) Listen intently and completely without interruption and listen deeply for the potential impact of anti-Black racism on patient health and interactions with health care; (3) Agree on what matters most by having explicit conversations about patient goals, treatment comfort and consent, and referral planning; (4) Connect with the patient's story, acknowledging socioeconomic factors influencing patient health and focusing on positive efforts; (5) Explore emotional cues by noticing and naming patient emotions, and considering how experiences with racism might influence emotions. P5RJ provides a framework with actionable communication practices to address pervasive racism experienced by Black patients. Effective implementation necessitates clinician self-reflection, personal commitment, and institutional support that offers time and resources to elicit a patient's story and to address patient needs.

Identifiants

pubmed: 35765147
doi: 10.1111/1475-6773.14015
pmc: PMC9660409
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

263-278

Subventions

Organisme : NIMHD NIH HHS
ID : U54 MD007586
Pays : United States

Informations de copyright

© 2022 Health Research and Educational Trust.

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Auteurs

Cati Brown-Johnson (C)

Evaluation Sciences Unit, Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

Joy Cox (J)

Meta Platforms, Inc., One Hacker Way, Menlo Park, California, USA.

Megha Shankar (M)

Division of General Internal Medicine, Department of Medicine, UC San Diego, San Diego, California, USA.

Juliana Baratta (J)

MIT Sloan School of Management, Cambridge, Massachusetts, USA.

Gisselle De Leon (G)

Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

Raquel Garcia (R)

Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

Taylor Hollis (T)

UAB Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA.

Mae Verano (M)

Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

Kelsey Henderson (K)

Meharry Medical College, Nashville, Tennessee, USA.

Mauranda Upchurch (M)

Guidehouse, Atlanta, Georgia, USA.

Nadia Safaeinili (N)

Health Policy and Management, UC Berkeley School of Public Health, Berkeley, California, USA.

Jonathan Glazer Shaw (JG)

Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

Robert J Fortuna (RJ)

University of Rochester Medical Center, Rochester, New York, USA.

Clyde Beverly (C)

Presence 5 for Racial Justice Community Advisory Board, Stanford University School of Medicine, Palo Alto, California, USA.

Meredith Walsh (M)

Church Health, Memphis, Tennessee, USA.

Carlie Stein Somerville (CS)

Primary Care at UAB Medicine Leeds, Leeds, Alabama, USA.

Marie Haverfield (M)

Communication Studies, College of Social Studies, San Jose State University, San Jose, California, USA.

Sonoo Thadaney Israni (ST)

Presence Center, Stanford University School of Medicine, Palo Alto, California, USA.

Abraham Verghese (A)

Presence Center, Stanford University School of Medicine, Palo Alto, California, USA.

Donna M Zulman (DM)

Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.

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