Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

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TitlePatient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.
Publication TypeJournal Article
AuthorsJenson A, Roter DL, Mkocha H, Munoz B, West S
Abbrev. JournalPatient Educ Couns
JournalPatient education and counseling
Year of Publication2018
Publication Languageeng
KeywordsCommunity treatment assistants, Mass Drug Administration (MDA), Neglected tropical diseases (NTDs), Patient-centered communication, Tanzania, Trachoma
Abstract

Objective
Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage.

Methods
In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA – villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012.

Results
58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009).

Conclusion
Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA.

Practice implications
Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers.

DOI10.1016/j.pec.2018.01.005