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

Autor: Brown-Johnson C; Evaluation Sciences Unit, Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA., Cox J; Meta Platforms, Inc., One Hacker Way, Menlo Park, California, USA., Shankar M; Division of General Internal Medicine, Department of Medicine, UC San Diego, San Diego, California, USA., Baratta J; MIT Sloan School of Management, Cambridge, Massachusetts, USA., De Leon G; Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA., Garcia R; Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA., Hollis T; UAB Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA., Verano M; Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA., Henderson K; Meharry Medical College, Nashville, Tennessee, USA., Upchurch M; Guidehouse, Atlanta, Georgia, USA., Safaeinili N; Health Policy and Management, UC Berkeley School of Public Health, Berkeley, California, USA., Shaw JG; Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA., Fortuna RJ; University of Rochester Medical Center, Rochester, New York, USA., Beverly C; Presence 5 for Racial Justice Community Advisory Board, Stanford University School of Medicine, Palo Alto, California, USA., Walsh M; Church Health, Memphis, Tennessee, USA., Somerville CS; Primary Care at UAB Medicine Leeds, Leeds, Alabama, USA., Haverfield M; Communication Studies, College of Social Studies, San Jose State University, San Jose, California, USA., Israni ST; Presence Center, Stanford University School of Medicine, Palo Alto, California, USA., Verghese A; Presence Center, Stanford University School of Medicine, Palo Alto, California, USA., Zulman DM; Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.
Jazyk: angličtina
Zdroj: Health services research [Health Serv Res] 2022 Dec; Vol. 57 Suppl 2, pp. 263-278. Date of Electronic Publication: 2022 Jul 18.
DOI: 10.1111/1475-6773.14015
Abstrakt: Objective: 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.
Data Sources: 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.
Study Design: 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.
Data Collection Methods: 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.
Principal Findings: 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.
Conclusion: 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.
(© 2022 Health Research and Educational Trust.)
Databáze: MEDLINE
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