Poster Session 4
Category: Health Equity/Community Health
Poster Session 4
Tenisha D. Wilson, MD, PhD
Maternal Fetal Medicine Physician
University of North Carolina
Chapel Hill, North Carolina, United States
Nia Plump, MPH
EleVATE Collaborative, St. Louis Integrated Health Network
St. Louis, Missouri, United States
Julia Muller, MPH
University of North Carolina
Chapel Hill, North Carolina, United States
Traci Johnson, MD
University of Missouri-Kansas City
Kansas City, Missouri, United States
Cheron Phillips
St. Louis Integrated Health Network
St. Louis, Missouri, United States
Richelle Smith
St. Louis Integrated Health Network
St. Louis, Missouri, United States
Kelly McKay-Gist, MSW
St. Louis Integrated Health Network
St. Louis, Missouri, United States
Catalina Montiel, MPH
University of North Carolina
Chapel Hill, North Carolina, United States
Maura Jones Pullins, MD (she/her/hers)
Fellow
University of North Carolina, Chapel Hill
Durham, North Carolina, United States
Jeannie C. Kelly, MD, MS (she/her/hers)
Associate Professor
Washington University School of Medicine
Washington University School of Medicine, Missouri, United States
Nandini Raghuraman, MD, MSCI
Associate Professor
Washington University School of Medicine
St. Louis, Missouri, United States
Melissa Tepe, MD, MPH
Affinia Healthcare
St. Louis, Missouri, United States
Candice L. Woolfolk, PhD, MPH
Assistant Professor
Washington University School of Medicine
Washington University School of Medicine, Missouri, United States
Shannon Lenze, PhD
Washington University in St. Louis, School of Medicine, Department of Psychiatry
St. Louis, Missouri, United States
Ebony Carter, MD, MPH (she/her/hers)
Maternal Fetal Medicine Physician, Division Director
University of North Carolina
Chapel Hill, North Carolina, United States
To examine the relationship between perceived healthcare discrimination and interpersonal communication quality in prenatal care across racial and ethnic groups using validated instruments.
Study Design:
Cross-sectional analysis of baseline data from 171 patients enrolled in a randomized trial of group prenatal care across three Missouri health systems. Perceived healthcare discrimination was measured using the Prenatal Interpersonal Processes of Care Discrimination (PIPC) subscale, and interpersonal communication/empathy with the Consultation and Relational Empathy (CARE) Measure. PIPC scores were grouped into terciles. Race/ethnicity distribution across terciles was assessed with chi-square tests. Differences in CARE scores across PIPC terciles were evaluated with Kruskal–Wallis tests, and by race/ethnicity using ANOVA with Tukey’s HSD post-hoc comparisons.
Results:
The sample included 171 patients: 61% Black/non-Hispanic (BNH) (n=104), 17% Hispanic (n=29), 18% White/non-Hispanic (WNH) (n=30), and 5% (n=8) another/non-Hispanic. Spanish was the primary language for all Hispanic participants. Patients in the highest discrimination tercile had significantly lower CARE scores (p=0.03). Discrimination varied by race, with Hispanic patients disproportionately represented in the highest tercile (59%) compared with BNH (28%) and WNH (27%) (p< 0.01). Among BNH patients, higher discrimination was associated with significantly lower CARE scores (p< 0.01). No significant associations were observed for Hispanic or WNH patients.
Conclusion:
Higher perceived healthcare discrimination was linked to poorer communication/empathy quality, with the strongest effects among BNH patients. Despite reporting the highest discrimination levels, Hispanic patients did not show reduced CARE scores, suggesting that language and cultural factors may influence how discrimination impacts perceived care quality. Findings underscore the need for targeted bias-reduction interventions and culturally responsive outcome measures.