title: How doctors' communication style and race concordance influence African-Caribbean patients when disclosing depression.
abstract: OBJECTIVE
  To determine the impact of doctors' communication style and doctor-patient race concordance on UK African-Caribbeans' comfort in disclosing depression.
  
  
  METHODS
  160 African-Caribbean and 160 white British subjects, stratified by gender and history of depression, participated in simulated depression consultations with video-recorded doctors. Doctors were stratified by black or white race, gender and a high (HPC) or low patient-centred (LPC) communication style, giving a full 2×2×2 factorial design. Afterwards, participants rated aspects of doctors' communication style, their comfort in disclosing depression and treatment preferences
  
  
  RESULTS
  Race concordance had no impact on African-Caribbeans' comfort in disclosing depression. However a HPC versus LPC communication style made them significantly more positive about their interactions with doctors (p=0.000), their overall comfort (p=0.003), their comfort in disclosing their emotional state (p=0.001), and about considering talking therapy (p=0.01); but less positive about considering antidepressant medication (p=0.01).
  
  
  CONCLUSIONS
  Doctors' communication style was shown to be more important than patient race or race concordance in influencing African Caribbeans' depression consultation experiences. Changing doctors' communication style may help reduce disparities in depression care.
  
  
  CONCLUSIONS
  Practitioners should cultivate a HPC style to make African-Caribbeans more comfortable when disclosing depression, so that it is less likely to be missed.
authors: Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: A.E.Adams@warwick.ac.uk.
authors: A
authors: A
authors: Adams
authors: Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: A.X.Realpe@warwick.ac.uk.
authors: A
authors: A
authors: Realpe
authors: Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: Laura.Vail@warwick.ac.uk.
authors: L
authors: L
authors: Vail
authors: Computer Science, Aston University, Birmingham, UK. Electronic address: c.d.buckingham@aston.ac.uk.
authors: C D
authors: CD
authors: Buckingham
authors: School of Public Health, Johns Hopkins University, Baltimore, USA. Electronic address: droter@jhsph.edu.
authors: L H
authors: LH
authors: Erby
authors: School of Public Health, Johns Hopkins University, Baltimore, USA. Electronic address: lori.erby@nih.gov.
authors: D
authors: D
authors: Roter
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D044383:Black People; D017691:Caribbean Region / Q000208:ethnology; D003142:Communication; D054521:Cultural Competency; D003863:Depression / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D012017:Referral and Consultation; D044465:White People
keywords: African–Caribbean; Depression disclosure; Depression treatment; Doctor–patient communication; Primary care; Racial disparities