title: Racial differences in attitudes regarding cardiovascular disease prevention and treatment: a qualitative study.
abstract: The objective of this study was to explore coronary heart disease (CHD) health care experiences and beliefs of African-American and white patients to elicit potential causes of racial disparities in CHD outcomes. Twenty-four patients (14 white, 10 African-American) with established CHD participated in one of four focus groups. Using qualitative methods, verbatim transcripts of the groups were analyzed by independent investigators to identify key themes. We identified four themes: risk factor knowledge, physician--patient relationship, medical system access, and treatment beliefs. Racial differences were apparent in the experience of racism as a stress, knowledge of specifics of CHD risk factors, and assertiveness in the physician--patient relationship. These findings suggest that strategies to improve risk factor knowledge and to enable African-American patients to become active partners in their medical care may lead to improved CHD morbidity and mortality in this population. The efficacy of such interventions would need to be tested in further work.
authors.affiliation: Houston Center for Quality of Care and Utilization Studies, Department of Veterans Affairs, Health Services Research and Development Center of Excellence, Houston Veterans Affairs Medical Center, Houston, TX 77030, USA. lwoodard@bcm.tmc.edu
authors.forename: Lechauncy D
authors.initials: LD
authors.lastname: Woodard
authors.forename: Marie T
authors.initials: MT
authors.lastname: Hernandez
authors.forename: Emily
authors.initials: E
authors.lastname: Lees
authors.forename: Laura A
authors.initials: LA
authors.lastname: Petersen
mesh_terms: D001741:Black or African American / Q000193:education / Q000208:ethnology*; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000401:mortality / Q000517:prevention & control*; D003431:Cross-Cultural Comparison; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000592:standards; D010817:Physician-Patient Relations; D011322:Primary Prevention / Q000379:methods; D036301:Qualitative Research; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014481:United States; D014493:United States Department of Veterans Affairs; D044465:White People / Q000193:education / Q000208:ethnology*