Graduation Year

2009

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Aging Studies

Major Professor

David A. Chiriboga, Ph.D.

Co-Major Professor

Yuri Jang, Ph.D.

Committee Member

Tamara Baker, Ph.D.

Committee Member

Mario Hernandez, Ph.D.

Committee Member

Keith Whitfield, Ph.D.

Keywords

Culture, Competency, Health Disparities, Interpersonal Sensitivity, Client-Provider Racial/Ethnic Concordance, Satisfaction with Care Received

Abstract

In response to the presence of health disparities among a diverse population of older adults, creating culturally competent health care services has emerged as a possible method to help reduce and eventually eliminate inequalities in health care. However, little information exists concerning the effectiveness of cultural competence, and even less is known about how culturally competent clients perceive their providers to be. This dissertation examined a number of indicators related to cultural competence, including the predictors of client-provider racial/ethnic concordance, client perceptions of the interpersonal sensitivity of their health care providers, and the overall satisfaction with care reported by older Non-Hispanic White, African American/Black, Hispanic/Latino, and Asian American adults. In order to accomplish these aims, three related studies were conducted, all drawing on data from the Commonwealth Fund 2001 Health Care Quality Survey. The first study focused on the factors that predicted racial/ethnic concordance between clients and their health care providers. The second study examined several factors that can affect the clients’ perception of their providers’ interpersonal sensitivity,

including client-provider racial/ethnic concordance. The third and final analysis utilized the outcome variables from the two previous studies, in addition to the client-level variables, to determine which factors predicted satisfaction with care received. The results show that the factors that predicted client-provider racial/ethnic concordance and perceived interpersonal sensitivity varied across the four groups. In addition, perceived interpersonal sensitivity was a significant predictor of satisfaction with care for all four of the groups. The findings from this dissertation contribute to a broader understanding of racial/ethnic differences in client-provider racial/ethnic concordance, perceptions of interpersonal sensitivity, and overall satisfaction with care among older adults from racially and ethnically diverse backgrounds.

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