Abstract D034: Patient and provider concordance and trust in providers among West African Immigrants: Findings from the CaPTC Familial Cohort Study
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Background Healthcare disparities among racial and ethnic groups have been well
documented across all aspects of clinical healthcare, and disparities in attainment of
preventive services are particularly prevalent. African immigrants may be particularly
susceptible to factors that contribute to healthcare disparities but little is known about
this population. The purpose of this study was to assess patient-provider concordance
and trust of health care providers among West African immigrants in the US. In addition,
we explored the relationship between these variables and the prostate cancer (CaP)
screening behavior of participants. Methods Data collection was part of a global study of
prostate cancer in West African men. A study questionnaire was used to collect data
from West African male immigrants in the US between the ages of 35 and 70 years.
Survey scales for this study included country of birth, years since immigration, patient–
provider concordance, trust of healthcare provider, attitude and cues towards CaP
screening (PSA and DRE), and CaP screening history. Results There were 38 African
immigrants from Cameroon, Nigeria, Sierra Leone, and Ghana. Participants’ average
age was 46.2 years and they had spent an average of 13.9 years in the US. Most of the
participants (over 60%) stated that they had no preference in regards to their provider
race, ethnicity or gender. Over 70% indicated that their physician was of different
ethnicity and race while 50% indicated that their physician was of a different gender.
Furthermore, most respondents noted that they trusted their physicians with health
decisions. However, 61% and 68% of participants did not complete PSA or DRE testing,
respectively. Most stated that they did not discuss the advantages or disadvantages of
prostate cancer screening with their physicians, noting they mostly received cues to
getting tested from reading information, radio, and/or TV. Conclusion Although health
disparities can be explained by socioeconomic status such as lack of insurance and
various other observable impediments to accessing health care, others barriers persist.
It is important to explore other contributing factors such as patient-physician
relationships. This study suggests that patient-provider concordance may not be a
priority. Emphasis should be placed on encouraging physician-initiated discussion on
CaP screening. Unfortunately, current physician guidelines do not stress CaP screening
and fail to account for the documented increased risk and early onset of CaP in Black Men.
Keywords
DT Africa, H Social Sciences (General)