We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Racial Disparities in Patient Activation: The Role of Economic Diversity.
- Authors
Holt, Jeana M.; Winn, Aaron; Cusatis, Rachel; Talsma, AkkeNeel; Crotty, Bradley H.
- Abstract
The Patient Activation Measure (PAM) assesses a person's level of knowledge, skills, and confidence to self-manage their day-to-day health. We conducted a mediation analysis to examine potential direct effects of race on significantly lower baseline PAM scores in Black than in White participants (p<0.001) who were a subset of 184 adults who participated in a randomized controlled trial. In the mediation analysis, using natural indirect effects, the continuous outcome was the PAM score. The mediators were income, education, ability to pay bills, and health literacy; race (Black or White) was the "exposure." The results indicate that income (p=0.025) and difficulty paying monthly bills (p=0.04) mediated the relationship between race and baseline PAM score, whereas health literacy (p=0.301) and education (p=0.436) did not. Researchers must further investigate the role of economic diversity as an underlying mechanism of patient activation and differences in outcomes. Clinical Trial Registration: Avoiding Health Disparities When Collecting Patient Contextual Data for Clinical Care and Pragmatic Research: NCT03766841 https://clinicaltrials.gov/ct2/show/NCT03766841?term=crotty&draw=2&rank=1
- Subjects
RACISM; STATISTICS; CONFIDENCE; CONFIDENCE intervals; PATIENT participation; SELF-management (Psychology); BLACK people; MATHEMATICAL models; FISHER exact test; RACE; HEALTH literacy; SOCIOECONOMIC factors; T-test (Statistics); INCOME; REPEATED measures design; THEORY; DESCRIPTIVE statistics; AT-risk people; FACTOR analysis; RESEARCH funding; WHITE people; EDUCATIONAL attainment
- Publication
Western Journal of Nursing Research, 2021, Vol 43, Issue 6, p517
- ISSN
0193-9459
- Publication type
Article
- DOI
10.1177/0193945920963130