J Gen Intern Med. 2026 Jun 1. doi: 10.1007/s11606-026-10528-x. Online ahead of print.
ABSTRACT
BACKGROUND: High-quality patient-centered communication (PCC) is associated with improved health outcomes. However, individuals from underrepresented racial/ethnic communities in the U.S. often experience poor PCC and disproportionately worse health outcomes compared to White individuals. Racial-ethnic-cultural (REC) belonging, defined as a sense of connection to one’s REC group that fosters feelings of value, acceptance, and security, represents an understudied aspect of community-based social support. Unlike related constructs like patient-provider racial concordance, REC belonging emphasizes individuals’ lived experiences of inclusion and may play an important role in moderating PCC, which functions as clinical social support.
OBJECTIVE: To examine potential associations between PCC and REC belonging and explore how REC belonging varies across sociodemographic factors.
DESIGN: Cross-sectional analysis of self-reported data from the National Cancer Institute’s Health Information National Trends Survey 7 (HINTS 7), a nationally representative survey of U.S. adults. Descriptive statistics identified sociodemographic patterns in REC belonging. Logistic regressions further explored differences in REC belonging across race/ethnicity. Linear regressions examined associations between REC belonging and PCC.
PARTICIPANTS: Respondents to HINTS 7 who reported visiting a healthcare clinician within the 12 months prior to survey completion (n = 5023).
MAIN MEASURES: PCC was assessed using the 7-item Patient-Centered Communication Scale (PCCS). REC belonging was assessed through agreement with a statement regarding a strong sense of belonging to one’s ethnic, racial, or cultural group, with responses categorized as “belonging” or “non-belonging.”
KEY RESULTS: Greater REC belonging was observed among non-White Hispanic (p < 0.001), heterosexual (p = 0.004), older (75+) (p = 0.006), non-liberal (p < 0.001), and non-married (p = 0.04) individuals. REC belonging was also significantly associated with higher PCC overall (β, 95% CI 4.97, 2.63-7.31).
CONCLUSIONS: Results showed an association between higher PCC and REC belonging. Understanding sociodemographic differences in REC belonging may guide community-based strategies to enhance communication, strengthen social support, and improve health outcomes in underrepresented communities.
PMID:42225874 | DOI:10.1007/s11606-026-10528-x
