ORCID

https://orcid.org/0000-0001-9710-3847

Date of Award

Summer 2025

Language

English

Embargo Period

7-26-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Communication

Program

Communication

First Advisor

Rukhsana Ahmed

Committee Members

Annis Golden, Jennifer Manganello

Keywords

patient-centered communication, immigrant health, Korean migrants, health literacy, cultural competence, mixed-methods research

Subject Categories

Health Communication | Health Services Research | Migration Studies

Abstract

Patient-Centered Communication (PCC) is defined as an approach that places patients at the center of communication with healthcare providers. PCC has been recognized as a strategy to address disparities experienced by minority populations. However, despite its associations with positive health outcomes and ethical significance, there has been a paucity of research on PCC in minority populations such as older Korean migrants in the U.S. Understanding PCC within this group may contribute to improving healthcare communication tailored to their needs. This dissertation aimed to (1) explore the expectations of PCC in primary care settings among older Korean migrants in the U.S., (2) adapt an existing PCC scale originally developed for cancer care, and (3) test the ecological model of medical encounters using the adapted PCC scale in primary care settings. This dissertation employed an exploratory sequential mixed-methods design, integrating qualitative and quantitative approaches, including interviews and surveys with samples recruited through community-based organizations (CBOs). In the qualitative phase, 21 semi-structured interviews with older Korean migrants in the U.S. revealed that certain aspects of PCC, such as non-verbal behaviors, providers’ self-disclosure, social, financial, and cultural circumstances, were absent in the existing PCC scale. Based on qualitative findings, the existing scale on PCC in cancer care was translated into Korean and adapted to primary care. In the quantitative phase, a survey was conducted with 229 participants recruited through CBOs. The adapted PCC scale was used to test the hypothesized model of PCC that includes ecological factors in the interpersonal, organizational, and cultural contexts. Hierarchical multiple regression analysis revealed that interpersonal and organizational factors, such as provider’s cultural competence, organizational health literacy, and organizational cultural competence, contributed to explaining variances in PCC, even after controlling for demographics, while cultural factors, such as ethnic and language concordance, were not significant predictors of PCC. The results highlighted the importance of organizational training and policies that enhance health literacy and cultural competence to support PCC in this population group. This dissertation contributes to advancing knowledge of patient-provider communication for racially and ethnically minoritized patients as well as to diversifying and expanding research on PCC through scale adaptation to a new care context and a new target population.

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This work is licensed under the University at Albany Standard Author Agreement.

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