The Influence of Face-to-face and E-mail Patient-provider Communication on Breast, Cervical, and Colorectal Cancer Screenings

Tiffany B Kindratt, The University of Texas School of Public Health

Abstract

Qualities and modes of patient-provider communication (PPC) contribute to more adults receiving cancer screenings. This study aims to determine associations between 1) face-to-face and 2) e-mail PPC and adults’ likelihood of receiving breast, cervical, and colorectal cancer screenings. Cross-sectional, secondary data analysis was conducted using nationally-representative 2011-2015 MEPS, 2011-2015 NHIS, and HINTS 4 Cycles 1-4 survey data. Adults reported how often physicians spent enough time with them; explained so they understood; listened to them; showed respect; gave them a chance to ask questions; addressed feelings and emotions; involved them in decisions; confirmed understanding; and helped them with uncertainty. Adults reported whether or not they used e-mail to communicate with their health care provider (e-mail PPC). Crude and adjusted logistic regression were used to evaluate the odds of receiving cancer screenings based on qualities of face-to-face and e-mail PPC. In adjusted models using HINTS data, adults reporting involvement in their decision making was associated with higher odds of receiving breast (OR=1.38; 95% CI=1.11, 1.71), cervical (OR=1.30; 95% CI=1.06, 1.60) and colorectal (OR=1.25; 95% CI=1.03, 1.51) cancer screenings. Similar results were found when evaluating associations between adults’ chances to ask questions and all cancer screenings (breast OR=1.28; 95% CI=1.04, 1.58; cervical OR=1.27; 95% CI=1.04, 1.55; colorectal OR=1.29; 95% CI=1.05, 1.57). Using MEPS data, giving specific instructions (breast OR= 1.19; 95% CI=1.06, 1.33; colorectal OR=1.23; 95% CI=1.10, 1.37) and the instructions were easy to understand (breast OR=1.13; 95% CI=1.03, 1.23; colorectal OR=1.10; 95% CI=1.01, 1.21) were most influential at increasing the odds of breast and colorectal cancer screenings. Using NHIS data, e-mail PPC increased the odds of receiving breast (OR=1.38; 95% CI=1.26, 1.50), cervical (OR=1.10; 1.02, 1.20) and colorectal (OR=1.55; 95% CI=1.42, 1.69) cancer screenings compared to adults who did not use e-mail PPC. No significant associations were observed using HINTS data. Several qualities of face-to-face PPC were influential on adults’ likelihood of receiving breast, cervical, and colorectal cancer screenings. Results from this study can be used to develop training to 1) empower patients to be more engaged in preventive health care practices and 2) educate health care providers on ways to apply these qualities when discussing screening recommendations with their patients. To our knowledge, this is the first study to evaluate the use of e-mail PPC and cancer screening. As more clinics encourage e-mail PPC, more research is needed to determine how best it can be incorporated into traditional health care visits.

Subject Area

Communication|Public health|Epidemiology

Recommended Citation

Kindratt, Tiffany B, "The Influence of Face-to-face and E-mail Patient-provider Communication on Breast, Cervical, and Colorectal Cancer Screenings" (2018). Texas Medical Center Dissertations (via ProQuest). AAI10837512.
https://digitalcommons.library.tmc.edu/dissertations/AAI10837512

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