title: Factors associated with patient-recalled smoking cessation advice in a low-income clinic.
abstract: It is recommended that providers advise cessation to their patients who smoke. However, patients' reports of cessation advice indicate disparities based on patients' race, gender, age, and smoking level. Providers' reports do not corroborate these disparities. We investigated whether smokers who receive their care in a community health center recalled their providers advising them to quit smoking when their providers documented such advice. We examined 219 patient-provider dyads to assess factors associated with lack of agreement between providers' documentation and patient recall. Patients were asked to recall any provider advice to quit smoking in the post 2 years. After every visit, providers completed a form to record the content of the visit. Most of the patients were African American, married, and uninsured. Sixty-eight percent of the dyads agreed in their documentation/recall. Patient race was the only factor associated with lack of agreement; African-American patients were more likely than white patients to provide discrepant reports. Although this study can not disentangle the racial difference in patient-provider recall/documentation, results may indicate an important area in which health disparities exist. Future studies should address the dynamics of patient-provider communication about smoking cessation, especially in populations that include ethnically diverse patients.
authors.affiliation: Duke Comprehensive Cancer Center, Cancer Prevention, Detection and Control Research Program, Durham, North Carolina 27710-2949, USA.
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.forename: Kimberly S H
authors.initials: KS
authors.lastname: Yarnall
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.forename: Isaac
authors.initials: I
authors.lastname: Lipkus
authors.forename: Pauline R
authors.initials: PR
authors.lastname: Lyna
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000706:statistics & numerical data*; D000368:Aged; D016022:Case-Control Studies; D003151:Community Health Centers / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina; D016017:Odds Ratio; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011203:Poverty; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011287:Prejudice; D016540:Smoking Cessation / Q000706:statistics & numerical data*