Ann Fam Med. 2022 Apr 1;20(20 Suppl 1):2819. doi: 10.1370/afm.20.s1.2819.
Context: The Presence for Racial Justice project leverages the Stanford Presence 5 framework to present anti-racism communication practices that promote clinician trust-building for Black patients in primary care. With the racial/ethnic disparities in COVID-19 infection rates, an assessment of Black patients' perspectives around COVID-19 care is required to promote health equity in current and future health crises. Objective: To compile clinician communication strategies for promotion of patient understanding and agency concerning Black patients' perceptions of COVID-19 vaccine, treatment and testing. Study design: Qualitative study employing inductive and deductive thematic analysis. Setting: Four primary care clinics primarily serving Black patients in Oakland, CA; Rochester, NY; Leeds, AL; and Memphis, TN. Population Studied: 37 Black patients, recruited through convenience sampling by their primary care clinician for 45-minute semi-structured audio-recorded interviews. Outcome Measures: Emergent themes around Black patient perceptions and motivations for seeking/delaying COVID-19 vaccine, treatment, and testing, and their ideal medical guidance on COVID-19 care. Results: Due to historic mistreatment of Black patients within the healthcare system, medicine, and research, there is a high prevalence of mistrust amongst the Black patient interviewees towards the safety, efficacy, and equitable distribution of the COVID-19 vaccine compared to existing vaccines. Patients feared racial discriminatory treatment and intended to wait for the general population, authority figures, and White patients to receive the vaccine first. Many patients believed personal protective behaviors (e.g., mask wearing, staying home, taking supplements) would be more effective than receiving the COVID-19 vaccine. They expressed a preference for receiving COVID-19 medical care in the comfort of their homes due to high costs and risks of maltreatment, death, and loneliness. Conclusion: Black patients hinged their vaccination decisions on having enough time to observe vaccine rollout and discussion with their clinicians. Relating new medical interventions (ie., COVID-19 vaccine) to accept medical approaches (ie., Flu vaccine) and being aware of historical distrust in medicine can inform clinician efforts to empower and provide excellent care for Black patients moving forward.
种族正义项目利用斯坦福存在 5 框架提出反种族主义沟通实践，以在初级保健中为黑人患者建立信任。鉴于 COVID-19 感染率存在种族/民族差异，需要评估黑人患者对 COVID-19 护理的看法，以促进当前和未来健康危机中的公平。目的：为促进患者对黑人患者对 COVID-19 疫苗、治疗和检测的看法的理解和代理感，编制临床医生沟通策略。研究设计：采用归纳和演绎主题分析的定性研究。地点：加利福尼亚州奥克兰、纽约州罗彻斯特、阿拉巴马州利兹和田纳西州孟菲斯的四家主要为黑人患者服务的初级保健诊所。研究人群：通过他们的初级保健医生通过便利抽样招募的 37 名黑人患者，进行 45 分钟的半结构式音频记录访谈。结果测量：围绕黑人患者对 COVID-19 疫苗、治疗和检测的看法和动机以及他们对 COVID-19 护理的理想医疗指导的出现主题。结果：由于历史上医疗保健系统、医学和研究中对黑人患者的虐待，受访者对 COVID-19 疫苗的安全性、有效性和公平分配存在高度不信任，与现有疫苗相比。患者担心受到种族歧视性待遇，并打算等待普通人群、权威人士和白人患者先接种疫苗。许多患者认为个人保护行为（例如，戴口罩、待在家里、服用补充剂）将比接种 COVID-19 疫苗更有效。他们表示，由于成本高和虐待、死亡和孤独的风险，他们更愿意在家中接受 COVID-19 医疗护理。结论：黑人患者将他们的疫苗接种决定取决于有足够的时间观察疫苗的推出并与他们的医生讨论。将新的医疗干预措施（即 COVID-19 疫苗）与接受医疗方法（即流感疫苗）相关联，并意识到对医学的历史不信任，可以为临床医生提供信息，以增强和为黑人患者提供出色的护理。
