There is substantial evidence that in the U.S. the health status of members of racial/ethnic minorities is poorer than that of non-Hispanic whites. Reducing health disparities is a major priority of the federal government. There are many reasons for these health disparities, but a large research literature suggests that 1 major cause is that poorer health care is provided to members of racial/ethnic minorities than to non-Hispanic whites. Although there are multiple reasons for this poorer health care, a recent Institute of Medicine Committee concluded that the attitudes and beliefs of both doctors and patients may play a major role by affecting the climate of medical interactions involving minority group members. This study will empirically examine the validity of this and other conclusions of the IOM committee and explore the efficacy of an intervention that is designed to reduce the impact of patient-physician attitudes and beliefs on medical interactions. Therefore the major aims of this study are to : (1) examine how patient and physician attitudes and beliefs directly affect the climate of medical interactions involving minority group patients and compare this to interactions with majority group patients (2)determine how the climate of medical interactions affect health-related behaviors and health status of minority patients, (3) investigate the effects of an intervention designed to create doctor-patient teams that work together to solve the patient's medical problems. This intervention is based on a social psychological model of reducing intergroup bias. The intervention is intended to reduce the effects of preexisting physician and patient attitudes and beliefs that may adversely affect the climate of medical interactions. Producing this change should result in better health-related behaviors and eventually the health status of minority patients. The study will be conducted in a large urban primary care clinic that primarily serves African-American patients. In the first phase of the study, the associations between patient/physician attitudes/beliefs and (a) the climate of medical interactions and (b) subsequent health-related behaviors and health status will be examined In the second phase, a randomized field experiment will be used to test the effectiveness of the intervention. If successful, the study should provide an exportable means of improving communication between physicians and minority group patients and reducing disparities in health care. ? ? ?
