Unmet Communication Needs and Barriers of Black and African Americans with Type 2 Diabetes

T2D is disproportionately prevalent among Black and African Americans (BAAs) and is one of the leading causes of mortality and morbidity among BAAs. T2D care is improved by patient-centered communication and Shared Decision Making (SDM). However, culturally sensitive T2D communication and SDM tools that focus on patient’s communication preferences, needs, and racial and cultural background that shape the interaction with a provider and influence treatment follow-up, are missing. The purpose of this formative study was to identify communication preferences, barriers, and needs of BAAs with T2D. Interviews were conducted with 32 BAAs with T2D served at a safety-net hospital located in a poor urban area. The sample included 17 women (53.1%), ages 31 to 81 years (58.9, SD=11.9), with a range of glycemic control (HbA1c: M=9, SD=2.7, range 6 to 14). A third (N=11) were prescribed oral medication and insulin, another third (N=11) were on oral medication only. A majority of participants (n=18, 56.3%) identified paternalistic communication, mistrust in the provider, and communication mismatch as barriers to T2D care. Receiving information about managing T2D in real-life situations (n=18, 56.3%) and patient-clinician collaboration in T2D decision-making (n=23, 72%) were the preferred communication strategies. A majority of participants stated expression of empathy, concern, and compassion by providers (n=22, 68.8%) and informal, open and direct communication (n=31, 96.9%) are needed to improve the quality of T2D care among BAAs. We identified several communication barriers and needs of BAAs with T2D with their providers, which interrupt their T2D management and treatment follow-up. There is an urgent need to improve patient-provider communication by developing culturally-sensitive communication support tools to address the communication needs and preferences of BAAs to improve SDM and the quality of diabetes care. Disclosure Y. Zisman-ilani: None. D. J. Rubin: Research Support; Self; AstraZeneca. L. A. Siminoff: None. M. L. Savoy: None. A. Paranjape: None. J. Liu: None. R. A. Jacob: None. H. M. Gardiner: None. S. B. Bass: None. V. M. Montori: None.