Debra Roter
Datos Biográficos
| ID | 1727640 |
|---|---|
| NOMBRE | Debra Roter |
| NOMBRES | Debra |
| APELLIDO | Roter |
| FIRMA | ROTER D |
| AFILIACIONES | Johns Hopkins University |
| ORCID | 0000-0003-2203-9697 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 53 |
| TOTAL DE CITAS | 224 |
| TOTAL COMO AUTOR | 53 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1977 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 7 |
Effects of Implicit Racial Bias and Standardized Patient Race on Genetic Counseling Students’ Patient-Centered Communication
Clinician racial bias has been associated with less patient-centered communication, but little is known about how it affects trainees’ communication. We investigated genetic counseling students’ communication during sessions with Black or White standardized patients (SPs) and the extent to which communication was associated with SP race or student scores on the Race Implicit Association Test (IAT). Sixty students conducted a baseline SP session a…
Parent–teacher communication for children on the autism spectrum
The purpose of this investigation was to examine communication skill use and related characteristics, as well as factors associated with problematic communication during conferences, in parents and teachers of children on the autism spectrum (AS). Participants were 36 parent–teacher dyads who completed questionnaires on communication, defined within the Listen, Educate, Assess, Partners, Support (LEAPS) Model, as well as measures on problem‐solvi…
Emotional Communication in HIV Care
Patient-level Predictors of Extent of Exposure to a Community Health Worker Intervention in a Randomized Controlled Trial
Differential exposure to a CHW intervention is influenced by patients' physical, psychosocial, and sociodemographic characteristics
Patient-provider communication styles in HIV treatment programs in Bamako, Mali
Effective patient-provider communication (PPC) promotes patient adherence and retention in long-term care. Sub-Saharan Africa faces unprecedented demand for chronic care for HIV patients on antiretroviral therapy (ART), yet adherence and retention remain challenging. In high-income countries, research describing patient preferences for different PPC styles has guided interventions to improve PPC and patient outcomes. However, research on PPC pref…
Effects of Minimal Versus Intensive Intervention to Enhance Motivational Interviewing in HIV Care
Breast and Cervical Cancer Screening Literacy Among Korean American Women
Objectives. To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women. Methods. We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland–Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led …
How Medical Interaction Shapes and Reflects The Physician-Patient Relationship
An exploration of patient and family engagement in routine primary care visits
BACKGROUND: Older adults are commonly accompanied to routine medical visits. Whether and how family companion behaviours relate to visit processes is poorly understood. OBJECTIVE: To examine family companion behaviours in relation to older adults' medical visit processes. DESIGN AND PARTICIPANTS: Observational study of 78 accompanied primary care patients ages 65 and older. MAIN OUTCOME MEASURES: Medical visit communication (coded using RIAS), pa…
Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients
BACKGROUND: Prior studies of acute abdominal pain provide conflicting data regarding the presence of racial/ethnic disparities in the emergency department (ED). OBJECTIVE: To evaluate race/ethnicity-based differences in ED analgesic pain management among a national sample of adult patients with acute abdominal pain based on a uniform definition. RESEARCH DESIGN/SUBJECTS/MEASURES: The 2006-2010 CDC-NHAMCS data were retrospectively queried for pati…
Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression
This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting …
Creating a Transdisciplinary Research Center to Reduce Cardiovascular Health Disparities in Baltimore, Maryland
Cardiovascular disease (CVD) disparities continue to have a negative impact on African Americans in the United States, largely because of uncontrolled hypertension. Despite the availability of evidence-based interventions, their use has not been translated into clinical and public health practice. The Johns Hopkins Center to Eliminate Cardiovascular Health Disparities is a new transdisciplinary research program with a stated goal to lower the imp…
Physician Communication Behaviors and Trust Among Black and White Patients With Hypertension
BACKGROUND: Racial differences in patient trust have been observed, but it is unclear which physician communication behaviors are related to trust, and whether the relationship of communication and trust differs among black and white patients. OBJECTIVE: We sought to determine whether there were associations between physician communication behaviors, visit process measures, and patient trust, particularly within racial groups. METHODS: Study part…
The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care
Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and pat…
Family presence in routine medical visits
Patients' Satisfaction With Male Versus Female Physicians
CONTEXT: Female physicians have a more patient-centered practice style than male physicians, and patient satisfaction is predicted by a more patient-centered practice style. OBJECTIVES: To assess whether there is a difference in patients' satisfaction with male versus female physicians and to examine moderators of this effect. DATA SOURCES: MEDLINE and PsycINFO databases and citation search through 2009, using keywords pertaining to patient satis…
Patient–Provider Communication Differs for Black Compared to White HIV-Infected Patients
Communication and Adherence
From the *Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and †Department of Psychology, Northeastern University, Boston, MA. Reprints: Debra L. Roter, DrPH, The Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Suite 750, Baltimore, MD 21205. E-mail: [email protected]
Assessing oral literacy demand in genetic counseling dialogue
Genetic counseling communication with an African American BRCA1 kindred
Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits
Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–N…
Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race
BACKGROUND: African-American patients who visit physicians of the same race rate their medical visits as more satisfying and participatory than do those who see physicians of other races. Little research has investigated the communication process in race-concordant and race-discordant medical visits. OBJECTIVES: To compare patient-physician communication in race-concordant and race-discordant visits and examine whether communication behaviors exp…
Patient adherence to HIV medication regimens
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–N…
The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care
Objectives. We examined the associations of clinicians’ implicit attitudes about race with visit communication and patient ratings of care. Methods. In a cross-sectional study of 40 primary care clinicians and 269 patients in urban community-based practices, we measured clinicians’ implicit general race bias and race and compliance stereotyping with 2 implicit association tests and related them to audiotape measures of visit communication and pat…
Quantitative and qualitative approaches to the evaluation of the medical dialogue
Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits
Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters
Physician vs patient initiation of psychotropic prescribing in primary care settings
The primary goals of this study were to examine: (1) whether patients were involved actively in initiating the prescribing of psychotropic medications during interactions with their primary care physicians and (2) what variables influenced patient vs physician initiation of psychotropic prescribing. An analysis of 508 audiotapes of physician-patient interactions and interviews with each patient and physician from 11 different ambulatory care sett…
Health promotion counseling of chronic-disease patients during primary care visits
OBJECTIVES. This study was designed to provide an empirical description, based on a review of visit audiotapes, of primary care practice with chronic-disease patients. METHODS. We analyzed 439 interactions between adult patients with chronic disease and 49 physicians. We explored the content, frequency, intensity, and dynamics of health promotion discussion during these routine visits. RESULTS. There was evidence of health promotion discussion in…
Psychosocial problem disclosure by primary care patients
Assessing oral literacy demand in genetic counseling dialogue
The relevance of client-centered communication to family planning settings in developing countries
Routine communication in sexually transmitted disease clinics
Sixty STD patients were followed during the course of their clinic visit which averaged 2.75 professional contacts. Based on audiotape analysis, virtually all patients received a diagnosis; however, 25 percent of the patients did not receive any information about treatment or prevention, and only 57 percent of patients were given complete information. Patient recall of the information they were given averaged about 43 percent. Patients not seen b…
Achieving patient compliance
Genetic counseling communication with an African American BRCA1 kindred
Breast and Cervical Cancer Screening Literacy Among Korean American Women
Objectives. To test a community health worker (CHW)-led health literacy intervention on mammogram and Papanicolaou test screening among Korean American women. Methods. We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland–Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led …
Patient Participation in the Patient-Provider Interaction
The purpose of this study was to investigate the effectiveness, dynamics, and consequences of a health education intervention designed to increase patient question asking during the patient's medical visit. Data were collected at a Baltimore family and community health center which provides outpatient services to a low income, predominantly black and female population. The majority of the study participants were, in addition, elderly and chronica…
Communication of Affect between Patient and Physician
Achieving patient compliance
Task Versus Socioemotional Behaviors in Physicians
This paper investigates associations among physicians' task-oriented and socioemotional behaviors during the medical encounter. The study is an analogue, using as source data the audiotapes and transcripts of two standardized patient cases presented by trained patient simulators to 43 primary care practitioners. Transcripts were scored for physician proficiency and were content-analyzed to assess the process of communication and information conte…
Relations Between Physicians?? Behaviors and Analogue Patients?? Satisfaction, Recall, and Impressions
This paper investigates associations between physicians' task-oriented and socioemotional behaviors, on the one hand, and analogue patients' satisfaction, recall of information, and global impressions. The study is based on role-playing subjects' responses to interactions between physicians and simulated patients. Audiotapes of two standardized patient cases presented by trained patient simulators to 43 primary care physicians were rated by role-…
Routine communication in sexually transmitted disease clinics
Sixty STD patients were followed during the course of their clinic visit which averaged 2.75 professional contacts. Based on audiotape analysis, virtually all patients received a diagnosis; however, 25 percent of the patients did not receive any information about treatment or prevention, and only 57 percent of patients were given complete information. Patient recall of the information they were given averaged about 43 percent. Patients not seen b…
Sex Differences in Patients?? and Physicians?? Communication During Primary Care Medical Visits
This study reports on the analysis of audiotapes of 537 adult, chronic disease patients and their 127 physicians (101 men and 26 women) in a variety of primary care practice settings to explore differences attributable to the effects of the patient's and the physician's sex on the process of communication during medical visits. Compared to male physicians, women conducted longer medical visits (22.9 vs 20.3 minutes; F(1,515) = 7.9, P less than .0…
Family Violence and the Evaluation of Behavioral Concerns in a Pediatric Primary Care Clinic
The goals of this study were to determine 1) the prevalence of exposure to intrafamilial violence among children attending a pediatric primary care clinic; 2) the prevalence of psychosocial distress among mothers bringing their children to the clinic; 3) the extent to which pediatricians are aware of family violence and maternal distress among their patients; and 4) whether families reporting violence are more likely to report behavioral or emoti…
Quantitative and qualitative approaches to the evaluation of the medical dialogue
Health promotion counseling of chronic-disease patients during primary care visits
OBJECTIVES. This study was designed to provide an empirical description, based on a review of visit audiotapes, of primary care practice with chronic-disease patients. METHODS. We analyzed 439 interactions between adult patients with chronic disease and 49 physicians. We explored the content, frequency, intensity, and dynamics of health promotion discussion during these routine visits. RESULTS. There was evidence of health promotion discussion in…
Physician Satisfaction With Primary Care Office Visits
To study encounter-specific physician satisfaction we collected exit questionnaires from patients and physicians following 550 primary care office visits. The physicians' questionnaire included 20 items pertaining to satisfaction with the visit, one of which was an assessment of global satisfaction. Using a boot-strap technique, we factor analyzed the satisfaction questions in 10 repeated samples. Four distinct dimensions of physician satisfactio…
Gender in medical encounters
Satisfaction, Gender, and Communication in Medical Visits
The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 was based on videotaped visits to a hospital-based internal medicine practice (n = 97 visits). Study 2 was based on audiotaped visits…
Patients' Health as a Predictor of Physician and Patient Behavior in Medical Visits
OBJECTIVES: Although some patient characteristics are known to be related to physician and patient communication in medical encounters, very little is known about the impact of patients' health status on communication processes. The authors assess relations of patients' physical and emotional health status to verbal and nonverbal communication between physicians and patients in four original studies, and combine results across the four studies us…
Physician vs patient initiation of psychotropic prescribing in primary care settings
The primary goals of this study were to examine: (1) whether patients were involved actively in initiating the prescribing of psychotropic medications during interactions with their primary care physicians and (2) what variables influenced patient vs physician initiation of psychotropic prescribing. An analysis of 508 audiotapes of physician-patient interactions and interviews with each patient and physician from 11 different ambulatory care sett…
Recruiting Physicians for Office-Based Research
OBJECTIVES: Research conducted in community outpatient offices can provide insight into the common experiences of patients and physicians. However, recruiting physicians to participate in office-based research is challenging and few descriptions of methods that have been used to successfully recruit random samples of physicians are available. This article describes recruitment strategies utilized in a project that achieved high rates of participa…
Effectiveness of Interventions to Improve Patient Compliance
OBJECTIVES: This article summarizes the results of 153 studies published between 1977 and 1994 that evaluated the effectiveness of interventions to improve patient compliance with medical regimens. METHODS: The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five…
Patient-Provider Communication During the Emergency Department Care of Children With Asthma
OBJECTIVES: Poor children's reliance on emergency facilities is one factor implicated in the rise of morbidity attributed to asthma. Although studies have examined doctor-patient communication during routine pediatric visits, little data are available about communication during emergency care. This study sought to describe communication during emergency treatment of childhood asthma to learn if a "patient-centered" provider style was associated w…
Asking Questions About Medication
OBJECTIVES: The purpose of this research was to examine physicians' and patients' question-asking about medications during medical encounters. METHODS: A dataset of 467 audiotapes and transcripts of outpatient visits, as well as postvisit interviews with chronic disease patients and their primary care physicians, was analyzed. RESULTS: All patients took at least one prescribed medication and were using an average of 3.9 continued medications. Phy…
Inaccuracies in Physicians' Perceptions of Their Patients
OBJECTIVE: The objective was to assess primary care physicians' awareness of their patients' rated emotions, satisfaction, and opinion of the quality of their communication. DESIGN: Diabetic patients (n = 261) and their primary care physicians (n = 44) each filled in a questionnaire following a routine medical visit. Patients were asked about the quality of communication with their physician, their satisfaction, and their experience of six emotio…
Psychosocial problem disclosure by primary care patients
The enduring and evolving nature of the patient–physician relationship
The medical visit context of treatment decision‐making and the therapeutic relationship
The ascendance of the autonomy paradigm in treatment decision‐making has evolved over the past several decades to the point where few bioethicists would question that it is the guiding value driving health‐care provider behaviour. In achieving quasi‐legal status, decision‐making has come to be regarded as a formality largely removed from the broader context of medical communication and the therapeutic relationship within which care is delivered. …
Recruitment of Research Participants from U.S. Jury Pools
Psychological research is often criticized for routine use of a narrow and unrepresentative study population-college students. This study investigated the feasibility of recruiting research participants from U.S. jury pools, which by law must include a representative cross-section of the public. A questionnaire was mailed to the jury administrators in the 217 U.S. state court jurisdictions with populations of 250,000 or more. Court officials repr…
Measuring Patient Expectations
BACKGROUND: Fulfillment of patients' expectations may influence health care utilization, affect patient satisfaction, and be used to indicate quality of care. Several different instruments have been used to measure expectations, yet little is known about how different assessment methods affect outcomes. OBJECTIVE: The object of the study was to determine whether different measurement instruments elicit different numbers and types of expectations …
Medicine (48 obras) · Psychology (41 obras) · Family medicine (39 obras) · Patient-Provider Communication in Healthcare (36 obras) · Nursing (25 obras) · Psychiatry (16 obras) · Patient Satisfaction in Healthcare (15 obras) · Clinical Psychology (14 obras) · MEDLINE (13 obras) · Internal Medicine (11 obras)