title: Exploring patient-provider interactions in a Native American community.
abstract: Identifying and addressing barriers and facilitators to good patient-provider clinical interactions may enhance participation in health-promoting behaviors. We used the critical incident technique to elicit descriptions of positive and negative patient-provider interactions from both patients and providers in a rural Native American community. Using the interview data, we developed a model that illustrates the factors affecting patient-provider interactions. Trust emerged as the central theme in the determination of whether an interaction is considered good or bad. Trust was influenced by four higher-level themes: visit context, visit expectations, history, and time. These higher-level themes also affected the perceived barriers and facilitators to the clinical interaction, which were categorized as either actions or feelings/interpretations. Addressing and reducing barriers to positive clinical interactions on multiple levels is necessary for improving patient trust in the health care system, particularly among members of minority groups.
authors.affiliation: Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. vanessa-simonds@uiowa.edu
authors.forename: Vanessa Watts
authors.initials: VW
authors.lastname: Simonds
authors.forename: Suzanne
authors.initials: S
authors.lastname: Christopher
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Sequist
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
authors.forename: Rima E
authors.initials: RE
authors.lastname: Rudd
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health / Q000208:ethnology*; D003153:Community Health Services; D055812:Community-Based Participatory Research; D003466:Cultural Characteristics; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D009009:Montana; D010817:Physician-Patient Relations; D036301:Qualitative Research; D019035:Rural Health Services; D035502:Trust