Publications
COMMUNICATING MEDICINE SERIES - JAMA
Vaccines and safe and highly effective at preventing disease. Yet, parents often have concerns about vaccine safety, efficacy, adverse reactions, and their long-term implications. In this article, Sean T. O’Leary, MD, MPH (University of Colorado Anschutz Medical Campus/Children’s Hospital Colorado, Aurora) outlines strategies that clinicians can use to address parent questions and concerns about vaccines. Effective evidence-based approaches to communicate about vaccines can help clinicians build trust, navigate difficult vaccine conversations, strengthen parental intention to vaccinate, and improve vaccine uptake.
Richard L. Kravitz, MD, MSPH (University of California Davis Division of General Internal Medicine) provides tips for clinicians in the careful management of patient requests for tests, referrals, and medications. Propelled by direct-to-consumer marketing of drugs and other health services, discussions around these issues often require clinical negotiation when patients request tests, medications, or treatments that a clinician may deem unsuitable, needless, or of little or no value. This is especially important to prevent overtreatment and navigate our fragmented healthcare system in an age of accelerating healthcare costs.
Charlotte Albury, DPhil (Nuffield Department of Primary Care Health Sciences, University of Oxford), Madeleine Tremblett, PhD (College of Health, Science and Society, University of the West of England, Bristol), and Paul Aveyard, PhD (Nuffield Department of Primary Care Health Sciences, University of Oxford) outline communication strategies for clinicians offering weight loss support to patients with obesity. Accounting for the fact that obesity is complex and chronic, clinicians should be mindful of not perpetuating weight stigma and bias in their language and communicate with respect and empathy in a nonjudgmental manner.
In this article, Bianca A. Allison, MD, MPH (Department of Pediatrics, University of North Carolina School of Medicine), Tracey A. Wilkinson, MD, MPH (Department of Pediatrics/Children’s Health Services Research, Indiana University School of Medicine), and Julie Maslowsky, PhD (Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing) emphasize the need for developmentally tailored communication on sex and reproductive health for adolescents. The authors outline evidence-based approaches that clinicians can use to counsel adolescents on contraceptive needs, pregnancy options, and STIs, including testing and treatment.
In this article, LaKesha N. Anderson, PhD, CPD (Department of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland) and Christy J.W. Ledford, PhD (Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta) outline three different types of explanations to help patients understand health recommendations that can be confusing: elucidating explanations, quasi-scientific explanations, and transformative explanations. The authors provide examples of clinical scenarios that illustrate commonly-faced obstacles to patient comprehension along with the associated strategies for explanatory communication.
Harm reduction is a clinical care strategy that aims to minimize the social and physical consequences of substance use while enabling patients to live healthier, self-directed lives without the assumption of abstinence as the ultimate goal. From a communication standpoint, effective harm reduction incorporates the approach of motivational interviewing, often defined as a “collaborative conversation style for strengthening a person’s own motivation and commitment to change.” In this article, Mary Hawk, DrPH, LSW (Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health); Raagini Jawa, MD, MPH (Center for Research on Health Care, Division of General Internal Medicine, School of Medicine and Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh); and Emma Sophia Kay, PhD, MSW (School of Nursing, University of Alabama at Birmingham) provide a communication framework that clinicians can use in practice to provide harm reduction care to patients.
Significant challenges in care are faced by patients with limited English-language proficiency as they are more likely to experience severe physical harm from healthcare errors compared with proficient speakers of English, as evidenced by several studies. In this article, Medical interpreters provide an important communication link between clinicians and patients with limited language proficiency. In this article, Zara Latif, MD (Division of Cardiology, Massachusetts General Hospital), Jane Kontrimas, CoreCHI, MS (Interpreter Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts), and Haider J. Warraich, MD (Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Office of the Commissioner, US Food and Drug Administration) offer practical steps to improve communication with remote interpreters for patients with limited English proficiency.
Word choices can profoundly affect clinical encounters, helping elicit empathy among patients, display clinician competence, and establish trust with patients. In this article, Jeffrey D. Robinson, PhD (Department of Communication, Portland State University) and Douglas J. Opel, MD, MPH (Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children’s Research Institute, University of Washington School of Medicine) provide examples of how subtle word changes can impact the information exchange between patients and clinicians, as well as patient uptake of health information and their adherence to recommended interventions.
Attenuated nonverbal cues and gestures exist in virtual care that are not generally of concern in in-person interactions in the clinic. Some examples include poor eye contact, sound-related issues, and distractions due to the environment. In this article, Matthew E. Hirschtritt, MD, MPH (Kaiser Permanente and the Department of Psychiatry and Behavioral Sciences, University of California, San Francisco) and Stephanie Kelly, PhD (Department of Business Information Systems & Analytics, North Carolina Agricultural and Technical State University, Greensboro) present best practices drawn from the fields of psychology, education, and health, to inform this fast-growing platform for clinical encounters. Their conclusions are based on rigorously-designed empirical research.
In this article, Sander van der Linden, PhD (Department of Psychology, School of Biology, University of Cambridge, Cambridge, United Kingdom) and Jon Roozenbeek, PhD (Department of War Studies, King’s College London, London, United Kingdom) describe effective methods for health professionals to psychologically "inoculate" patients against misinformation by enabling them to identify inaccurate health information by warning them about misleading medical information they are bound to encounter and avoid accepting it as fact. Such an approach can help prevent adoption and acceptance of inaccurate health information, avoid dangerous behaviors, and improve health.
In this article, Kathleen Hall Jamieson, PhD (Annenberg Public Policy Center, University of Pennsylvania); Kevin Johnson, MD, MS (Perelman School of Medicine, University of Pennsylvania); and Anne Cappola, MD, ScM (Perelman School of Medicine and PMCRI, University of Pennsylvania), recommend renaming the Vaccine Adverse Event Reporting System (VAERS), a national system of self-reported events managed by the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC). The current name inaccurately suggests active surveillance and report validation, increasing public susceptibility to misconceptions about vaccine safety.
In this article, Joseph N. Cappella, PhD (Annenberg School for Communication, University of Pennsylvania) and Richard L. Street, Jr. (Department of Communication & Journalism, Texas A&M University) outline communication strategies that can be used by clinicians to enhance information gathering and exchange, motivate engagement by patients, and improve comprehension and information retention, thereby promoting acceptance and adherence.
In this article, PMCRI Executive Director Dr. Anne Cappola and JAMA Editor-in-Chief Kirsten Bibbins-Domingo introduce the new JAMA series kicked off my Cappola and Cohen's article, Strategies to Improve Medical Communication. The goal of the series is to introduce clinicians to various approaches and strategies to enhance communication of medicine and health-related topics to patients.
In this article, PMCRI Executive Director Dr. Anne Cappola and Director of Research and Operations Karthika Cohen give an overview of various strategies that can be employed in medical communication, with a focus on the message, messenger, and social context. Approaches such as persuasive messaging through narratives, empathetic communication, prebunking interventions, the social norm approach, and harm reduction have been used with success in various fields such as public health, psychology, social science, and marketing. Cappola and Cohen provide a framework for the use of such strategies in the clinical setting. This introductory article kicked of the Communicating Medicine series in JAMA.
PMCRI PILOT GRANT AWARDEE PUBLICATIONS
- Johnson KB, Iannone SL, Furth SL, Taylor L, Tan ASL. Culturally Tailored Messages and Trial Registry Enrollment: A Randomized Clinical Trial. JAMA Netw Open. Nov 12 2024;7(11):e2444229. doi:10.1001/jamanetworkopen.2024.44229
- Girginova K, Vadala J, Tan A, Okker-Edging K, Cassidy K, Lipman T, Kornides M. Augmented Landscapes of Empathy: Community Voices in Augmented Reality Campaigns. Media and Communication. Oct 21 2024; 12, Article 8581. https://doi.org/10.17645/mac.8581
- Gupta R, Friedman AB, McCoy MS. Medical journals and advertiser tracking-Consequences for patients, clinicians, and editors. Digit Health. Aug 6 2023; 9:20552076231176654. doi:10.1177/20552076231176654
- Golos AM, Guntuku S, Buttenheim AM, “Do not inject our babies”: a social listening analysis of public opinion about authorizing pediatric COVID-19 vaccines. July 8 2024. Health Affairs Scholar. 2 (7) qxae082, https://doi.org/10.1093/haschl/qxae082