Non-Hispanic Blacks (NHB) have a higher burden of T2DM and experience worse outcomes than Non-Hispanic Whites (NHW). Patient and system factors do not fully explain these disparities. We conducted a cross-sectional study of NHB and NHW with T2DM receiving care in 34 primary care practices. We examined the association between HbA1c (glycemic control), patient race, and the Interpersonal Processes of Care survey (IPC) which is divided into 7 subdomains describing the patient-provider relationship. These include hurried communication, elicited concerns and responded, explained results and medications, patient-centered decision making, compassionate and respectful, discriminated, and disrespectful office staff. We used adjusted linear regression to examine association between IPC subdomains, HbA1c and race. Due to large ceiling and floor effects we dichotomized IPC subdomains to the strongest endorsement and at least one answer that was not the strongest endorsement.

A total of 106 NHW and 115 NHB completed the study. The mean age of participants was 64.4 and 55% were female. The average HbA1c of the sample was 7.3%; 7.4% for NHB and 7.3% for NHW. There were no significant main effects of the IPC subscales; however, we found statistically significant race interactions for two of the IPC subscales. The HbA1c was on average 0.45% lower [-1, 0.1] among NHB who reported no hurried communication versus NHB who reported some hurried communication (p=0.48). Similarly, HbA1c was on average 0.64% lower [-1.19, -0.08] among NHB who fully endorsed that their providers explained results and medications compared to those who did not (p=0.01). The relationship between these subdomains and improved glycemic control was not observed in NHW.

These findings indicate that hurried communication and lack of explanation may contribute to worse glycemic control in NHB. Interventions aimed at improving these aspects of the patient-provider relationship may reduce racial disparities in glycemic control.


H. Reid: None. O. Lin: None. R.L. Fabbro: None. M. Olsen: None. S.T. Chung: None. K.S. Johnson: None. B. Batch: None.


National Center for Advancing Translational Sciences (TL1TR002555)

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