TY - JOUR
T1 - Clients’ Perspectives on Patient-Centeredness
T2 - a Qualitative Study with Low-Income Minority Women Receiving HIV Care in South Florida
AU - Fernandez, Sofia B.
AU - Ward, Melissa K.
AU - Ramírez-Ortiz, Daisy
AU - Flores, Annette
AU - Santander, Taidiana Gonzalez
AU - Dawit, Rahel
AU - Ibarra, Cynthia
AU - Garcia, Ashley
AU - Ladner, Robert
AU - Brock, Petra
AU - Jean-Gilles, Michele
AU - Ibañez, Gladys
AU - Dévieux, Jessy
AU - Beach, Mary Catherine
AU - Trepka, Mary Jo
N1 - Funding Information:
This work was supported by awards R01MD013563, R01MD013563-02S1, U54MD012393 and in part by F31MD015234 from the National Institute on Minority Health and Health Disparities.
Publisher Copyright:
© 2022, W. Montague Cobb-NMA Health Institute.
PY - 2023/4
Y1 - 2023/4
N2 - Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients’ preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.
AB - Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients’ preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.
KW - Adherence and retention in care
KW - Delivery of healthcare
KW - Human immunodeficiency virus
KW - Medical care provider
KW - Medical case manager
KW - Patient-centered care
KW - Racial and ethnic minorities
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U2 - 10.1007/s40615-022-01281-y
DO - 10.1007/s40615-022-01281-y
M3 - Article
C2 - 35426056
AN - SCOPUS:85128036168
SN - 2197-3792
VL - 10
SP - 930
EP - 941
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 2
ER -