Patient-Centered Communication and Racial-Ethnic-Cultural Belonging Among United States Adults.

Abstract

High-quality patient-centered communication (PCC) is associated with improved health outcomes. However, individuals from underrepresented racial/ethnic communities in the U.S. often experience poor PCC and disproportionately worse health outcomes compared to White individuals. Racial-ethnic-cultural (REC) belonging, defined as a sense of connection to one's REC group that fosters feelings of value, acceptance, and security, represents an understudied aspect of community-based social support. Unlike related constructs like patient-provider racial concordance, REC belonging emphasizes individuals' lived experiences of inclusion and may play an important role in moderating PCC, which functions as clinical social support. To examine potential associations between PCC and REC belonging and explore how REC belonging varies across sociodemographic factors. Cross-sectional analysis of self-reported data from the National Cancer Institute's Health Information National Trends Survey 7 (HINTS 7), a nationally representative survey of U.S. adults. Descriptive statistics identified sociodemographic patterns in REC belonging. Logistic regressions further explored differences in REC belonging across race/ethnicity. Linear regressions examined associations between REC belonging and PCC. Respondents to HINTS 7 who reported visiting a healthcare clinician within the 12 months prior to survey completion (n = 5023). PCC was assessed using the 7-item Patient-Centered Communication Scale (PCCS). REC belonging was assessed through agreement with a statement regarding a strong sense of belonging to one's ethnic, racial, or cultural group, with responses categorized as "belonging" or "non-belonging." Greater REC belonging was observed among non-White Hispanic (p < 0.001), heterosexual (p = 0.004), older (75+) (p = 0.006), non-liberal (p < 0.001), and non-married (p = 0.04) individuals. REC belonging was also significantly associated with higher PCC overall (β, 95% CI 4.97, 2.63-7.31). Results showed an association between higher PCC and REC belonging. Understanding sociodemographic differences in REC belonging may guide community-based strategies to enhance communication, strengthen social support, and improve health outcomes in underrepresented communities.