title: Increasing patient participation in reproductive health consultations: an evaluation of "Smart Patient" coaching in Indonesia.
abstract: Paternalistic models of health care, social distance between patients and providers, and cultural norms discourage patients from playing an active role in health consultations. This study tested whether individual coaching can give family planning patients the confidence and communication skills to talk more openly and more vigorously with providers. Educators met with 384 Indonesian women in clinic waiting rooms and coached them on asking questions, expressing concerns, and seeking clarification. An analysis of audiotaped consultations found that patients who received coaching articulated significantly more questions and concerns than others. Coaching narrowed differentials in active communication by patient type, age, and assertiveness, but it widened differentials by patient education and socioeconomic class. The discontinuation rate at 8 months was lower in the intervention than the control condition, but the difference was only marginally significant.
authors.affiliation: Johns Hopkins University Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD 21202-4024, USA. ykim@jhuccp.org
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Kim
authors.forename: Fitri
authors.initials: F
authors.lastname: Putjuk
authors.forename: Endang
authors.initials: E
authors.lastname: Basuki
authors.forename: Adrienne
authors.initials: A
authors.lastname: Kols
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001242:Assertiveness; D003142:Communication; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D007214:Indonesia; D008875:Middle Aged; D017145:Models, Educational; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods* / Q000523:psychology; D015397:Program Evaluation; D012017:Referral and Consultation; D018456:Reproductive Medicine; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014930:Women / Q000193:education* / Q000523:psychology