Testing of a Model with Latino Patients That Explains the Links Among Patient-Perceived Provider Cultural Sensitivity, Language Preference, and Patient Treatment Adherence

Abstract

Introduction: Disparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers.

Purpose: The purpose of this study was to examine whether patients' perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients.

Methods: Data from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients.

Results: No significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence.

Conclusion: These results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.

Keywords: Latinos; Patient-provider interactions; Provider cultural sensitivity; Treatment adherence.

Fig. 1

Modified patient-centered culturally sensitive health care (PC-CSHC) model

Fig. 2

Standardized parameter estimates for full sample data (n = 555, all parameters had critical ratios >1.96)

Fig. 3

Standardized parameter estimates for English-preferred Latinos reduced model (n = 196, all parameters had critical ratios >1.96)

Fig. 4

Standardized parameter estimates for Spanish-preferred Latinos reduced model (n = 361, all parameters had critical ratios >1.96)