The Role of Patient Activation on Patient-Provider Communication and Quality of Care for US and Foreign Born Latino Patients

Previous research has shown positive effects of patient activation on healthcare outcomes, but there is practically no information on the generalization of these findings for Latino patients. Little data are available on whether patient activation is associated with healthcare outcomes for Latino patients and whether activation varies by language proficiency and nativity status. We examined the levels of activation by characteristics of Latino patients (e.g. nativity, language, health status). We investigated whether patient activation relates to the quality of care received and enhanced doctor-patient communication for Latino patients. We conducted analyses of 1,067 US born and foreign born Latinos who participated in the second wave of the PEW/RWJF Hispanic Healthcare Survey during 2008. Participants were self-identified Latinos (18+) with a doctor visit, living in the contiguous United States who could be contacted by telephone. US born Latinos had significantly (P < 0.001) greater patient activation scores than foreign born Latinos (75 versus 70). Latinos classified as bilingual and those reporting excellent health evidenced higher mean activation scores as compared to Spanish-speaking Latinos and those reporting fair or poor health. After adjusting for demographics, health status, other language and service use factors, patient activation was strongly associated with self-reported quality of care and better doctor-patient communication among both US and foreign born Latino respondents. Interventions that augment patient activation could increase quality of care and improved patient-provider communication, potentially reducing health care disparities for Latinos.