Recruiting Ethnically Diverse General Internal Medicine Patients for a Telephone Survey on Physician-Patient Communication

Authors

  • Anna M. Nápoles-Springer PhD,

    1. Center for Aging in Diverse Communities, Medical Effectiveness Research Center for Diverse Populations, Division of General Internal Medicine, University of California, San Francisco, CA, USA
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  • Jasmine Santoyo MSc,

    1. Center for Aging in Diverse Communities, Medical Effectiveness Research Center for Diverse Populations, Institute for Health and Aging, University of California, San Francisco, CA, USA.
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  • Anita L. Stewart PhD

    1. Center for Aging in Diverse Communities, Medical Effectiveness Research Center for Diverse Populations, Institute for Health and Aging, University of California, San Francisco, CA, USA.
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  • The authors have no conflicts of interest to report.

  • A poster was presented at the Society of General Internal Medicine 27th annual meeting, Chicago, IL, May 15, 2004.

Address correspondence and requests for reprints to Dr. Nápoles-Springer: University of California San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94118-1944 (e-mail ans@medicine.ucsf.edu).

Abstract

Background: Limited evidence exists on the effectiveness of recruitment methods among diverse populations.

Objective: Describe response rates by recruitment stage, ethnic-language group, and type of initial contact letter (for African-American and Latino patients).

Design: Tracking of response status by recruitment stage and ethnic-language group and a randomized trial of ethnically tailored initial letters nested within a cross-sectional telephone survey on physician-patient communication.

Participants: Adult general medicine patients with ≥1 visit during the preceding year, stratified by 4 categories: African-American (N= 1,400), English-speaking Latino (N= 894), Spanish-speaking Latino (N= 965), and non-Latino white (N= 1,400).

Measurements and Results: Ethnically tailored initial letters referred to shortages of African-American (or Latino) physicians and the need to learn about the experiences of African-American (or Latino) patients communicating with physicians. Of 2,482 patients contacted, eligible, and able to participate (identified eligibles), 69.9% completed the survey. Thirty-nine percent of the sampling frame was unable to be contacted, with losses higher among non-Latino whites (46.5%) and African Americans (44.2%) than among English-speaking (32.3%) and Spanish-speaking Latinos (25.1%). For identified eligibles, response rates were highest among Spanish-speaking Latinos (75.2%), lowest for non-Latino whites (66.4%), and intermediate for African Americans (69.7%) and English-speaking Latinos (68.1%). There were no differences in overall response rates between patients receiving ethnically tailored letters (72.2%) and those receiving general letters (70.0%).

Conclusions: Household contact and individual response rates differed by ethnic-language group, highlighting the importance of tracking losses by stage and subpopulation. Careful attention to recruitment yielded acceptable response rates among all groups.

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