title: An unequal burden: poor patient-provider communication and sickle cell disease.
abstract: OBJECTIVE
  To assess disparities in the quality of healthcare provider communication experienced by African-American adults with and without sickle cell disease (SCD) in the U.S.
  
  
  METHODS
  Poor provider communication was assessed by the Provider Communication subscale of the Consumer Assessment of Healthcare Plans and Systems survey. The SCD sample was obtained from participants in a multicenter observational study of healthcare experiences. The national African-American sample data was obtained from published national estimates.
  
  
  RESULTS
  The SCD sample was more likely than the national sample to report poor communication in 3 out of 4 communication domains: listening (22.3% vs. 11.5%, p<0.0001); showing respect (26.1% vs. 9.5%, p<0.0001); and spending enough time (38.3% vs. 16.2%, p<0.0001). Differences were consistent in young, but not old, patients and showed some variation by self-reported health status and education.
  
  
  CONCLUSIONS
  The communication difficulties experienced by persons with SCD do not appear reducible to their predominantly African-American race, but may result from more disease-specific factors.
  
  
  CONCLUSIONS
  Healthcare providers should take particular care in recognizing and demonstrating recommended communication skills with SCD patients as these patients may be particularly vulnerable to, and cognizant of, poor quality interactions.
authors.affiliation: Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, USA. Electronic address: chaywoodjr@jhu.edu.
authors.forename: Carlton
authors.initials: C
authors.lastname: Haywood
authors.affiliation: Department of Psychology, The University of Maryland, Baltimore County, Baltimore, MD 21205, USA.
authors.forename: Shawn
authors.initials: S
authors.lastname: Bediako
authors.affiliation: Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lanzkron
authors.affiliation: Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Diener-West
authors.affiliation: Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: John
authors.initials: J
authors.lastname: Strouse
authors.affiliation: Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Haythornthwaite
authors.affiliation: Department of Medicine, The Howard University Hospital, Washington, USA.
authors.forename: Gladys
authors.initials: G
authors.lastname: Onojobi
authors.affiliation: Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000755:Anemia, Sickle Cell / Q000208:ethnology / Q000523:psychology*; D003142:Communication; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D015995:Prevalence; D011787:Quality of Health Care; D055815:Young Adult
keywords: Healthcare disparities; Patient–provider communication; Sickle cell disease