Treating and Precepting with RESPECT: A Relational Model Addressing Race, Ethnicity, and Culture in Medical Training

Mostow, Carol; Crosson, Julie; Gordon, Sandra; Chapman, Sheila; Gonzalez, Peter; Hardt, Eric; Delgado, Leyda; James, Thea; David, Michele

doi:10.1007/s11606-010-1274-4

Cited by 41 publications

(28 citation statements)

References 47 publications

(42 reference statements)

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“…Cardiologists’ ability to recognize and act upon the sociodemographic factors contributing to their patients’ health and health-related behaviors is crucial to bending the curve of disparities. Recognition and understanding of the social determinants of disease can then guide patient-centered care strategies and bolster patient adherence 41–43 .…”

Section: How Can the Epidemiological Evidence About Social Determinanmentioning

confidence: 99%

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A Tale of Two Patients

2016

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The disparate effects of social determinants of health (SDOH) on cardiovascular (CV) health status and health care have been extensively documented by epidemiology. Yet, very little attention has been paid to how understanding and addressing SDOH might improve the quality of clinical interactions, especially by improving patients’ adherence to recommended therapies. We present a case and suggested approach to illustrate how cardiovascular clinicians can use patient-centered approaches to identify and address SDOH barriers to adherence and reduce the impact of unconscious clinician biases. We propose that CV clinicians 1) Recognize that patients may have different belief systems about illnesses’ cause and treatment, which may influence their actions, and not to assume they share one’s experiences or explanatory model; 2) Endeavor to Understand the individual patient before you; 3) Based on that understanding, Tailor your approach to that individual. We suggest a previously-developed mnemonic for an approach to RESPECT the patient: First, show Respect; then elicit patients’ understandings of their illness by asking about their Explanatory model. Ask about the patient’s Social context, share Power in the interaction, show Empathy, ask about Concerns or fears, and work to develop Trust by building the relationship over time. We provide additional clinical resources to support these efforts, including lay descriptions of cardiovascular conditions, challenges to adherence and suggested strategies to address them.

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Section: How Can the Epidemiological Evidence About Social Determinanmentioning

confidence: 99%

“…Asking directly about social context may uncover important barriers to adherence that can be addressed – by the physician or other members of the healthcare team 43 .…”

Section: The Cases: Two Different Patients Illustrate the Varying Infmentioning

confidence: 99%

A Tale of Two Patients

2016

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“…', we offer the skills model and training materials published in 'Treating and precepting with RESPECT; a relational model addressing race, ethnicity and culture in medical training'. 3 We developed RESPECT because our work as clinicians and educators at an inner city safety net hospital identified essential elements for building trust with patients from backgrounds that differed greatly in culture or power status from their providers. Accumulating data regarding communication disparities further supported these components.…”

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confidence: 99%

R-E-S-P-E-C-T: Physician-Patient Communication

et al. 2014

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“…Understanding how consumers in specific sociocultural settings view a given health problem is essential in developing effective, targeted social marketing messages to influence positive health behaviors and health-seeking (Mostow et al, 2010). In this article, we compare cultural models of osteoporosis shared among older women in the study region with those embedded in social marketing messages on osteoporosis.…”

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confidence: 99%

A Cultural Models Approach to Osteoporosis Prevention and Treatment

Otmar

Reventlow²,

Morrow

et al. 2012

Sage Open

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This article identifies cultural models of osteoporosis, as shared by community-dwelling older women in southeastern Australia, and compares these with cultural knowledge conveyed through social marketing. Cultural models are mental constructs about specific domains in everyday life, such as health and illness, which are shared within a community. We applied domain analyses to data obtained from in-depth interviews and stakeholder-identified print materials. The response domains identified from our case studies made up the shared cultural model "Osteoporosis has low salience," particularly when ranked against other threats to health. The cultural knowledge reflected in the print materials supported a cultural model of low salience. Cultural cues embedded in social marketing messages on osteoporosis may be internalized and motivating in unintended ways. Identifying and understanding cultural models of osteoporosis within a community may provide valuable insights to inform the development of targeted health messages.

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Treating and Precepting with RESPECT: A Relational Model Addressing Race, Ethnicity, and Culture in Medical Training

Abstract: Precepting with RESPECT fosters a safe climate for residents to partner with faculty, address challenges with patients at risk, and improve outcomes.

Cited by 41 publications

References 47 publications

A Tale of Two Patients

A Tale of Two Patients

R-E-S-P-E-C-T: Physician-Patient Communication

A Cultural Models Approach to Osteoporosis Prevention and Treatment

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