University of Kentucky
Perceived Barriers to Communication with Health Providers and Influences on Health Outcomes in Appalachian Communities
Institution
University of Kentucky
Faculty Advisor/ Mentor
Gia Mudd Martin; Debra K. Moser
Abstract
Introduction: Appalachian communities experience significant health disparities compared with other U.S. communities. Communication barriers between patients and health providers have been associated with poor health outcomes. The purpose of this qualitative study was to explore perceptions of health provider communication and influences on health services among Appalachian residents in Kentucky. Method(s): A qualitative study was conducted in Appalachian communities as part of a larger study to develop a heart health intervention. Three focus groups were conducted (n = 34) with purposive sampling to recruit participants using a semi-structured discussion guide. Focus groups were audio taped and the transcriptions analyzed using qualitative description. Text specific to provider communication was coded and a code network developed to identify themes. Results: Several themes emerged from the data. Unclear communication by health providers was the most prevalent and impeded participants’ understanding of health issues and contributed to feelings of inadequacy. Intimidation was also a barrier, with participants describing providers as unapproachable and interactions uncomfortable. Another barrier was a lack of continuity of care. Attendance by various providers and fragmented services were described as being disruptive to the development of trust, diminishing open communication. Discussion & Conclusions: Research on health communication barriers in Appalachian populations is limited. This study indicates that the use of language appropriate to the level of client understanding and development of consistent client-provider relationships can reinforce client self-confidence and engender comfort and trust. More effective communication guided by the findings has the potential to influence health outcomes in Appalachian communities.
Perceived Barriers to Communication with Health Providers and Influences on Health Outcomes in Appalachian Communities
Introduction: Appalachian communities experience significant health disparities compared with other U.S. communities. Communication barriers between patients and health providers have been associated with poor health outcomes. The purpose of this qualitative study was to explore perceptions of health provider communication and influences on health services among Appalachian residents in Kentucky. Method(s): A qualitative study was conducted in Appalachian communities as part of a larger study to develop a heart health intervention. Three focus groups were conducted (n = 34) with purposive sampling to recruit participants using a semi-structured discussion guide. Focus groups were audio taped and the transcriptions analyzed using qualitative description. Text specific to provider communication was coded and a code network developed to identify themes. Results: Several themes emerged from the data. Unclear communication by health providers was the most prevalent and impeded participants’ understanding of health issues and contributed to feelings of inadequacy. Intimidation was also a barrier, with participants describing providers as unapproachable and interactions uncomfortable. Another barrier was a lack of continuity of care. Attendance by various providers and fragmented services were described as being disruptive to the development of trust, diminishing open communication. Discussion & Conclusions: Research on health communication barriers in Appalachian populations is limited. This study indicates that the use of language appropriate to the level of client understanding and development of consistent client-provider relationships can reinforce client self-confidence and engender comfort and trust. More effective communication guided by the findings has the potential to influence health outcomes in Appalachian communities.