| Background. Evidence suggests that poor communication with providers and problematic patient-provider relationships among racial/ethnic minorities plays an important role in health care disparities. Understanding the process of African American women's patient-provider interaction and how it affects the patient-provider relationship- quality of prenatal care, and adherence to prenatal health behaviors is needed.;Objective. To describe how patient characteristics (preference for race concordance, perceived racism, and depressive symptomatology) and patient-provider interaction (patient-provider communication and provider discrimination) influence African American women's trust in provider, prenatal care satisfaction, and adherence to prenatal health behaviors (return visit, getting prenatal labs drawn, receiving ultrasounds, and taking prenatal vitamins) using the Interaction Model of Client Health Behavior (IMCHB);Methods. In this descriptive, exploratory study, pregnant African American women (n=204) between the ages of 1 8-45 years and their providers (n=21) were recruited from a prenatal clinic associated with a large health system in Southeastern Michigan. Surveys were used to assess women and provider perceptions of patient-provider interaction, trust in provider, and prenatal care satisfaction at the initial prenatal visit. Women's adherence to provider recommended prenatal health behaviors at the initial visit were assessed at the subsequent prenatal visit via face to face interview.;Results. Patient-provider communication had a significant positive effect on trust in provider (beta= 0.75, p <.001. R2 .56) and on prenatal care satisfaction (beta= 0.81, p <.001. R2 .70). Perceived racism had a negative, significant effect on trust in provider (beta= -0.35, p < .001, R 2 .12) and prenatal care satisfaction (beta= -0.26, p <.001. R2 .05). Preference for race concordance, depressive symptomatology, and provider discrimination did not influence trust in provider, prenatal care satisfaction and adherence to prenatal health behaviors. Adherence to prenatal health behaviors was not predicted by the concepts of patient singularity, patient-provider interaction, trust in provider and prenatal care satisfaction.;Conclusions. High quality patient-provider communication leads to greater trust in provider and higher prenatal care satisfaction among pregnant African American women. Providers need to he aware of the negative effects of racism that can contribute to poor healthcare relationships and lower quality of prenatal care. |
