Author ORCID Identifier

https://orcid.org/0000-0003-4821-0456

Date of Award

1-5-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Educational Psychology and Special Education

First Advisor

Dr. Daphne Greenberg

Second Advisor

Dr. Iris Feinberg

Third Advisor

Dr. Amy Lederberg

Fourth Advisor

Dr. Hongli Li

Abstract

Many patients have difficulty communicating with their healthcare providers (Aldoory, 2017; Brooks et al., 2020; Watson, 2019). Teach-Back is an evidence-based health literary communication tool that is useful for ensuring patients understand the information they receive; with evidence after exposure to Teach-Back, patients exhibit increased disease-specific knowledge, adherence, self-efficacy, and improved health outcomes (Hong et al., 2020a; Talevski et al., 2020). Healthy People 2030 endorsed Teach-Back as an intervention for improving patient comprehension of health information in clinical settings (ODPHP, 2020). However, Teach-Back has not been widely implemented in these settings (Brooks et al., 2020). Not much is known regarding the comprehensive factors which predict clinicians’ use of Teach-Back. This study is a follow-up to Feinberg et al. (2019) which found medical residents increased their use of Teach-Back after attending an educational presentation. Variables not examined in the original analysis are explored in the following research questions: After an educational intervention, is there a significant relationship between patients’ exposure to Teach-Back by medical residents and patients’ highest educational level, perceived health status, diagnoses, reason for visit, new or returning patient status, gender and/or the conversation length during consultation? What are the relationships between the total number of times Teach-Back is used post-intervention and the medical resident’s age, gender, race, or main language? Bivariate and Kendall’s tau correlations revealed new or returning patient status (χ2 = 5.430, p < .05) and conversation length (rt = .307, p < .01), respectively, were significantly associated with patient’s Teach-Back exposure after the residents’ participation in the training intervention. The subsequent binary logistic regression revealed only conversation length (B = .061, p < .05) was a significant predictor of Teach-Back exposure. No statistically significant relationships between the total number of times Teach-Back was used post-intervention and medical residents’ personal characteristics were found. Findings add to original study results of factors which facilitate Teach-Back exposure. Longer consultations and new patient visits were more likely to involve Teach-Back use than other factors. Given the benefits of Teach-Back for all patients, a universal precautions approach is recommended to facilitate its widespread adoption in clinical settings.

DOI

https://doi.org/10.57709/36381557

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