Interpersonal processes of care in diverse populations

Milbank Q. 1999;77(3):305-39, 274. doi: 10.1111/1468-0009.00138.


Persons of lower socioeconomic status and members of racial and ethnic minority groups experience poorer health and increased health risk factors. A framework of interpersonal processes of care specifies distinct components and incorporates the perspective of diverse racial and ethnic or socioeconomic groups. Its dimensions, each with several domains, are communication (general clarity, elicitation of and responsiveness to patient concerns, explanations, empowerment), decision making (responsiveness to patient preferences, consideration of ability and desire to comply), and interpersonal style (friendliness, respectfulness, discrimination, cultural sensitivity, support). All the domains, except cultural sensitivity, were validated through a survey of 603 ethnically diverse, low-income adults. Confirmation of the framework's usefulness should enable researchers to explore how interpersonal processes might account for observed ethnic and social class differences in health care and health.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Communication
  • Cultural Diversity*
  • Disclosure
  • Empirical Research
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Minority Groups*
  • Patient Participation
  • Patient Satisfaction
  • Physician-Patient Relations*
  • Quality of Health Care*
  • San Francisco
  • Social Values
  • Socioeconomic Factors
  • Vulnerable Populations*