Homework 5 For this homework, please read the enclosed article and answer the following questions: Perrault, E. K. (2020) The utility of healthcare providers’ biographies for first-time patients: A study within a clinical setting. Health Communication, 35(10), 1283-1288. https://doi.org/10.1080/10410236.2019.1625005 1. What is the general topic of this article? 2. What is Hypothesis 4 of the study? What is the corresponding null hypothesis? 3. What is the independent or “grouping” variable for Hypothesis 4? Is it a nominallevel variable or an ordinal-level variable? 4. What is the dependent variable for Hypothesis 4? How was it measured in the study? 5. What is the t value for the independent samples t-test conducted for Hypothesis 4? Was it statistically significant? How do you know? 6. What is the value given for partial Cohen’s d? Is this a small, medium, or large effect size? Health Communication ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/hhth20 The Utility of Healthcare Providers’ Online Biographies for First-Time Patients: A Year-Long Study within a Clinical Setting Evan K. Perrault To cite this article: Evan K. Perrault (2020) The Utility of Healthcare Providers’ Online Biographies for First-Time Patients: A Year-Long Study within a Clinical Setting, Health Communication, 35:10, 1283-1288, DOI: 10.1080/10410236.2019.1625005 To link to this article: https://doi.org/10.1080/10410236.2019.1625005 Published online: 04 Jun 2019. Submit your article to this journal Article views: 85 View related articles View Crossmark data Citing articles: 2 View citing articles Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=hhth20 HEALTH COMMUNICATION 2020, VOL. 35, NO. 10, 1283–1288 https://doi.org/10.1080/10410236.2019.1625005 The Utility of Healthcare Providers’ Online Biographies for First-Time Patients: A Year-Long Study within a Clinical Setting Evan K. Perrault Brian Lamb School of Communication, Purdue University ABSTRACT Despite recommendations to provide patient-centered care (i.e., empowering patients to take a greater role in their care), healthcare systems still lag behind in helping patients make arguably one of their most important decisions – their initial selection of a primary care provider. While prior highly-controlled, theoretically-guided, experimental research has tested how various presentations of provider information may impact patients’ decision-making processes, no studies to date have taken the next step to actually roll out improvements to providers’ online information in a real-world healthcare organization and assess their effects. Over the course of a year, the current study made improvements to the website of a health clinic (i.e., adding biographies of primary care providers, & including short video introductions). Post-consultation questionnaires completed by first-time patients revealed patients who naturally viewed online biographies prior to setting appointments indicated less uncertainty – which was mediated through increases in perceived similarity – and were more likely to purposely select their providers. Patients who purposely selected their providers also reported greater patient satisfaction, and were more likely to choose providers with whom they perceived greater similarity. Similarity and patient satisfaction were also positively related. Overall, findings indicate online provider biographies can help patients become more purposive participants in their care, which can lead to greater patient satisfaction. Introduction To date, the majority of research conducted to determine the effect that various components of primary care providers’ online biographies have on patients’ perceptions and decisionmaking processes has been of a highly controlled nature (e.g., Perrault, 2018a; Perrault & Silk, 2015, 2016). However, a key limitation of these types of studies has been that participants need to be primed to imagine they are selecting a provider for the first time, and then artificially exposed to various permutations of provider biographies. While these previous studies offer high levels of internal validity, they inherently lack ecological validity. Ultimately, the findings these kinds of studies have produced are only useful if they can be applied in a real-life clinical setting when patients are actually deciding on a provider to visit. Therefore, the following study utilized a quasi-experimental design over the course of a year at the health center of a large university to determine the effects of various presentations of provider information on the center’s website for first-time patients. Literature review Biographies as uncertainty reducing tools Selecting a primary care provider for the first time is an important decision, and one many patients like to research. A recent survey of almost 4,000 Americans found 88% sought information about healthcare providers before making their selections – the most popular location being online biographies (Perrault & Hildenbrand, 2018). It is therefore clear that patients have some degree of uncertainty in this selection process, and seek information in order to reduce it. While healthcare organizations do not have much control over how family members or friends will portray a potential healthcare provider to a prospective patient (i.e., an active means of uncertainty reduction), these organizations do have complete control over how they portray their providers through their online biographies (i.e., a passive means of uncertainty reduction). Prospective patients can easily gather this information from the comforts of their own homes, without having to burden others, to try to predict how various providers might act in future consultations. Uncertainty reduction theory (URT) offers guidance on the content of information to include within biographies likely to produce the least uncertainty. URT posits increasing similarities between individuals should lead to reductions in uncertainty (Berger & Calabrese, 1975). While we can be physically similar to targets in the ways we look, our age, gender, or ethnicity, we can also be attitudinally similar to each other via common interests or shared perspectives (McCroskey, McCroskey, & Richmond, 2006). Potential conduits to increase attitudinal similarities through providers’ biographies CONTACT Evan K. Perrault perrault@purdue.edu Brian Lamb School of Communication, Purdue University, 100 N. University Street, West Lafayette, IN 47907, USA. Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/hhth. © 2019 Taylor & Francis Group, LLC 1284 E. K. PERRAULT could be through the inclusion of care philosophies and their providers (e.g., care philosophies, ways they communicate in personal interests of providers. This type of information can consultations, information to humanize the provider) healthcare also help to humanize providers, and showcase them as real organizations should consequently be helping to achieve one of the people, which is important to patients (Smith, Braunack- goals of PCC. As a result: Mayer, Wittert, & Warin, 2008; Willes, 2018). Prior experimental research has found including this information within H3: A greater proportion of new patients who view online bioprovider biographies can reduce uncertainty greater than bio- graphies prior to their visits will report purposely choosing their graphies containing only professional information (Perrault & providers compared to those who did not view biographies. Silk, 2015, 2016). Given these findings, all biographies produced for this study included information about providers Reviews of PCC have generally found that PCC is associated that prior research indicated could help patients perceive with a host of positive outcomes for patients (Robinson et al., similarities between themselves and the providers. Therefore, 2008). For example, PCC-related practices have been related a mediation path model is hypothesized whereby biography to improved patient health outcomes (Stewart et al., 2000), viewing among new patients should be positively related to greater patient adherence (Zolnierek & DiMatteo, 2009), and perceived similarities, which should be related to decreases in greater patient satisfaction (Moran, Bekker, & Latchford, uncertainty: 2008). Therefore, given that the empowerment of patients to make their own healthcare decisions is a primary component H1: Biography viewing – (+)→ Perceived Similarity – (-)→ of PCC, it is hypothesized that: Uncertainty H4: Patients who report purposely selecting their providers will have greater satisfaction with their encounters than patients who did not. Utilizing videos The information present within biographies is likely not the only variable that has the power to help new patients reduce uncertainty. The modalities through which that information is presented may also have an impact. While online biographies of providers have generally been text-based (Perrault & Smreker, 2013), some healthcare organizations do provide short video introductions of providers (Perrault, 2014). Again, in highly controlled experiments, short videos of providers have been related to greater uncertainty reduction (Perrault, 2018a; Perrault & Silk, 2016). The reason why videos may lead to less uncertainty rests in their ability to provide a “richer” experience, rather than reading “leaner” media like a text-only story (Daft & Lengel, 1984). Unlike a text-only description of someone’s care philosophy, the medium of video can actually demonstrate both verbal and nonverbal behaviors that show precisely how that provider would likely communicate with patients in future interactions. Therefore, Similarity and choice Individuals’ willingness to disclose information with others is likely related to how similar we view those individuals to ourselves (Berger & Calabrese, 1975; Rogers & Bhowmik, 1970). For example, URT posits that the “intimacy level of communication content and similarity are positively related” (Berger & Calabrese, 1975, p. 109). In the case of new provider-patient relationships, patients are often expected to disclose highly personal information with a complete stranger to aid the provider in coming to an accurate diagnosis. Therefore, it seems logical that: H5: Patients who purposely selected their providers will report greater perceived similarities with the providers they visited than patients who did not. H2: New patients who viewed video introductions of providers prior to their visits will report less uncertainty than those Additionally, if patients perceive greater levels of similarity who viewed text-only biographies. with their providers, they may tend to feel more satisfied with their care. Perrault and Silk (2016) found that participants who were provided biographies that included similarityinducing information reported greater anticipated patient Patient-centered care satisfaction than participants exposed to biographies that A prevalent concept in healthcare is the provision of patient- only included professional information. Therefore, centered care (PCC; Epstein & Street, 2011). Key components of providing PCC are helping patients become more active and H6: Perceived provider similarity will be positively related to involved participants in the medical decision-making process to patient satisfaction. achieve individualized care (Robinson, Callister, Berry, & Dearing, 2008). For example, in Davis, Schoenbaum, and Audet’s (2005) elucidation of PCC, one of their seven key components is the offering of publicly available information about provider practices, Methods “information by which a patient could choose a physician or Project development and biography creation a practice most likely to meet the patient’s needs” (p. 954). Therefore, by providing patients the information previous Cooperation from the health center at a large, public, research indicates they desire to make an informed decision of Midwestern university was instrumental in ensuring HEALTH COMMUNICATION successful completion of this project. As part of the center’s ongoing quality improvement, tablet computers are placed at the clinic’s exit asking patients to complete various satisfaction items after each visit. The director of the health center allowed the addition of supplementary questions to this survey in order to test the efficacy of biographical improvements made to the center’s website over the course of a year. First, in order to provide evidence that improvements to the health center’s website were needed, a question during Fall 2016 asked new patients if they had tried to find information on the health center’s website prior to their visits about the various providers who worked there. More than one-third of new patients surveyed (35.9%) indicated they had been to the health center’s website to seek more information about its providers. This result provided justification to the center’s management and staff that patients had a desire for more information about providers. At that time, the center’s website provided no information about the providers it employed, not even names – a rarity among Division-I universities (Perrault, 2018b). Text biographies After these results were obtained, the author worked with the center’s providers and staff to develop standardized text biographies of each of the 15 primary care providers the clinic employed. Information included within the biographies was based on prior research related to increasing perceived similarity (Perrault & Silk, 2016), as well as what is prominently displayed within online provider biographies on student health centers’ websites (Perrault, 2018b). Biographies included: the provider’s education, professional interests and specializations, length of time working at the center, why they like working at the center, their philosophies of care, and what they like to do when they are not working at the center. Website staff helped to create the biography templates, as well as prominently placing a link on the homepage of the health center’s website asking visitors to “Meet Our Providers.” The biographies went live on the website at the start of the 2017 spring semester. Video biographies During summer 2017 the author, who is also a former television journalist, conducted on-camera interviews with 11 of the 15 providers, and created short video biographies of each one to be placed within each of the providers’ online biographies. The videos were shot interview-style, in an exam room, with only the provider’s head and shoulders showing. Each interview lasted about 10 min. Standard questions included: how long they have been practicing; why they got into medicine; what a normal day looks like at the clinic; what they love about their jobs; why they like to practice medicine; how a patient would describe a consultation with them; and what they like to do outside of the clinic. The videos were then edited to between 39 and 108 s (mean length = 74.5 s) and usually contained answers to three or four of the questions that were asked.1 These videos were then placed on the center’s website at the start of the fall 2017 semester. Measures Given directives from health center management to not substantially increase the length and time it would take patients to 1285 complete the post-visit survey, most of the measures used to test the study’s hypotheses were single- or double-item measures. Biography viewing One yes/no item asked patients whether they viewed online biographies regarding the center’s providers prior to their visit. This item was only provided to patients after biographies were placed on the center’s website (starting spring 2017). In fall 2017, after videos were placed online, an additional yes/no question was added asking whether they viewed videos of providers on the center’s website prior to their visit. Uncertainty Uncertainty was measured using one 7-point Likert scaled item (1 = strongly disagree, 7 = strongly agree); “prior to my visit today, I felt like I knew how the provider would interact with me.” This item was then reverse coded so that higher scores would indicate greater levels of uncertainty. This item was measured after biographies were placed on the center’s website in spring 2017. Provider selection One question asked all patients to select how they decided to visit the provider they visited for that day’s visit, either: “I purposely chose which provider I wanted to visit today – made a conscious selection,” or “I chose to visit whichever provider was readily available – Didn’t care who I saw.” Patient satisfaction Patient satisfaction was measured among all patients using three semantic differential items on 7-point scales adapted from the satisfaction with physician scale (Richmond, Smith, Heisel, & McCroskey, 1998). Patients were asked to indicate how: displeased/pleased, dissatisfied/satisfied, and uncomfortable/comfortable they were with the care they received in that day’s visit (α = .919). Perceived similarity Perceived similarity was measured among all patients with two, seven-point Likert scale items adapted from McCroskey et al. (2006): “the provider I visited today thinks like me”; and, “I can relate to the provider I visited today” (rSB = .85).2 Participants During the course of data collection (November 2016 – December 2017), 16,985 post-visit surveys were at least partially completed by patients. These data were then reduced to only include those who indicated that it was their first time visiting the health center (n = 3,290). These data were further reduced by excluding patients (n = 121) who indicated they had previously interacted with the provider they saw at their first visit. Finally, responses lacking more than 50% of their data completed were also removed (n = 716) leaving a final sample of n = 2,453. Of those who chose to provide demographic information (n = 1,970), 48.3% identified as male, and 50.5% as female. Forty-percent were freshmen, 16.7% sophomore, 12.3% juniors, 7.6% seniors, 22.5% graduate students, and 0.6% 1286 E. K. PERRAULT spouse/partner of a student. Fifty-seven percent identified as Caucasian, followed by 28.2% Asian, 6.6% Hispanic, 3.2% African American, and 4.7% other. Patients ranged in age from 18 to 69 (M= 20.64). viewing biographies before their visits, 35.1% (n = 100) purposely chose their provider, compared to 10.7% (n = 179 of 1,676) who purposely chose their provider but did not look at any online biographies. Therefore, hypothesis 3 is supported. Results Hypothesis 4 Hypothesis 1 Hypothesis 4 predicts patients who purposely selected their providers (n = 328; M = 6.67, SD = 0.70) would have greater satisfaction with their encounters than those who did not (n = 1,998; M = 6.57, SD = 0.80). An independent samples t-test revealed a significant finding,5 t (482) = 2.27, p = .02, Cohen’s d = .13; Therefore, hypothesis 4 is supported. Hypothesis 1 predicts a mediation model, whereby biography viewing among new patients should be positively related to perceived similarity with the provider, and subsequent reductions in uncertainty. The analysis was conducted using Hayes (2017) PROCESS macro for SPSS. Patient biography viewing before their appointments was coded as either 1 or 0 (1 = viewed biographies prior to appointment [n = 297], 0 = did not view biographies [n = 1,667]). The results of the analysis revealed support for hypothesis 1, where biography viewing’s relation to decreased uncertainty was significantly mediated by patients’ perceived similarity with the providers (see Figure 1). In other words, viewing biographies helped to reduce patients’ uncertainty by helping them perceive greater similarities with their providers.3 Hypothesis 5 Hypothesis 5 predicts that patients who purposely selected their providers (n = 332; M = 5.50, SD = 1.18) would report greater perceived similarities with the providers they visited than patients who did not (n = 1,995; M = 5.12, SD = 1.18). Again, an independent samples t-test was used, finding a significant result, t (2325) = 5.49, p < .001, Cohen’s d = .32. Therefore, hypothesis 5 is supported. Hypothesis 2 Hypothesis 6 An independent samples t-test was used to test hypothesis 2, that patients who viewed video introductions prior to their visits would have less uncertainty than patients who only viewed text biographies. Because text biographies were also present alongside video biographies during the second half of the study, only patients who indicated reading text biographies during the first phase of the study were included in this analysis. While the means trended in the right direction – viewed video (n = 69; M = 3.08, SD = 1.49), viewed text (n = 130; M = 3.20, SD = 1.64) – the overall finding was nonsignificant, t (197) = 0.48, p= .63. Therefore, hypothesis 2 was not supported.4 Hypothesis 6 predicts perceived provider similarity and patient satisfaction would be positively related. The correlation between these two variables was significant, r (2314) = .314, p < .001. The more similar new patients felt toward their providers, the more satisfaction those patients had with their visits. Thus, the data are consistent with the hypothesis. Hypothesis 3 Hypothesis 3 predicts patients who viewed online biographies prior to their visits would be more likely to purposely select their providers than those who did not view biographies. A chi-square analysis resulted in a significant finding, χ2 (1, n = 1961) = 118.9, p < .001. Of the 285 patients who indicated Discussion This study was the first attempt in a real clinical setting to determine the impact of providing online biographical information of providers to first-time patients when they are selecting primary care providers. Results revealed online biographies developed using theoretical guidance and prior research can lead to less patient uncertainty and assist patients in becoming more purposive consumers in their provider selection – a key component of providing PCC. This study also found that patients who purposely select their providers tend to choose those with whom they perceive a greater level of similarity. Greater perceived similarity was also related to greater patient satisfaction. The following discussion outlines some limitations of the current study, future directions to take this research, as well as some lessons learned in working with a real healthcare client. Limitations and future directions Figure 1. Biography viewing’s effect on uncertainty as mediated through perceived similarity. Note: – Path coefficients are unstandardized.- (*) indicates significance at p < .001- The non-mediated path coefficient between Biography Viewing and Uncertainty was −.354* Unlike previous experimental research (e.g., Perrault & Silk, 2016), this study was unable to find significant differences between viewing video and text biographies in their uncertainty reducing capabilities. One of the reasons for this could be a limitation inherent in the measurement of uncertainty itself. In this research, the only way to measure uncertainty HEALTH COMMUNICATION was by measuring uncertainty after patients’ interactions had already taken place, and asking patients to recall the level of uncertainty they felt with their providers prior to coming to the clinic for their visits. Therefore, significant uncertainty reduction may have actually occurred prior to interactions – mean differences in the proper direction provide some support for this – but the strength of the uncertainty reduction measured in this study was likely attenuated because patients’ perceptions were clouded due to the fact that they just completed their first interaction with their provider (i.e., uncertainty was now completely reduced). Ideally, future research would ask patients’ perceptions of their uncertainty before their first interactions with providers, and then pair these results with measures that need to take place after interactions occur (e.g., patient satisfaction). If post-visit measures can only occur, a substitute measure for uncertainty reduction could potentially be expectancy violation (Afifi & Burgoon, 2000). For example; did the provider act in the consultation the way the patient thought the provider would act? This type of measure would then be able to determine which medium of biography, text or video, provided the most accurate representation of how the consultations actually unfolded. Another limitation is that all of the videos produced were not of the same length. From a practical standpoint, this was unavoidable because some providers offered shorter answers to questions, while others were more verbose. This limitation should not be considered too concerning as previous research finds that it might not take much video at all (less than 30 s) for individuals to be able to accurately predict personality and performance characteristics of targets (Ambady & Rosenthal, 1993). Due to the fact that producing numerous video biographies of healthcare providers can get quite costly – one production company charges $3,000 for 90-s clips (Medical Web Experts, 2018) – future research should determine what the shortest, or optimal, length of a video introduction might be. Finally, due to length constraints for the post-visit survey imposed by the health center, scales with multiple items, and additional measures, were unable to be included. For example, these constraints precluded our ability to ask what other sources of information, if any, patients utilized to try and gather information about the providers. This research found that after biographies were placed on the center's website, 179 new patients indicated they purposely selected their providers but did not view the online biographies. It would be interesting to determine in future studies where this patient population is seeking information to make their purposive selection of providers (e.g., friends, family, social media). This information could provide useful information to healthcare providers on where else they could be targeting resources to provide greater PCC to help patients make the more informed decisions. 1287 controlled experiment in an online lab setting that could be conceptualized and carried out in the span of days or weeks, the current research required securing buy-in not only from the manager of the clinic but also from all of the medical providers the clinic employs. For example, it took multiple meetings with clinic management, as well as preliminary data collection, to convince them that there was a need for improving how providers were presented on the clinic’s website. Then, it required meeting with all of the providers during a staff meeting to broach the idea of the project and answer any questions they had. Next, questionnaires had to be distributed and collected from providers to build content for their online biographies, and time slots had to be coordinated with a photographer to take headshots of the providers. Webpages had to be created from scratch, and the providers had to be offered time before the webpages went live to provide final feedback on how their biographies looked. Concessions also had to be made regarding the complexity of data collection. As Parrott and Steiner (2003) note, once provided access to a clinical setting researchers need to avoid the tendency to be greedy and ask for too much. This indeed was the case in developing the additional survey questions to be added to the clinic’s existing exit survey to help answer this study’s hypotheses. Multi-item scales, and additional openended questions had to be jettisoned in order to keep the survey short so that the clinic could continue to collect the quality improvement data it needed for its own formal reporting requirements. However, tradeoffs of this type are necessary if we ever hope to test whether findings generated in laboratory settings can actually work in real life. Conclusions As this research revealed, previous findings from laboratory settings did extend to real clinical practice. Patients who viewed healthcare providers’ online biographies prior to their appointments had less uncertainty and were more likely to purposely choose their providers than those who did not view biographies. Patients who purposely selected their providers reported greater similarities with their providers, as well as greater satisfaction with their visits. These results support the importance of providing PCC to empower patients in their healthcare decision-making (Davis et al., 2005; Epstein & Street, 2011), and helping them select clinicians they believe will provide the best care. This has important downstream effects, as patients who have greater satisfaction with their care tend to visit providers more frequently (Roghmann, Hengst, & Zastowny, 1979), which means they are more likely to be seen for preventive services. Thus, potentially serious conditions can be detected earlier. One small step toward achieving improved population health could be as simple as helping patients more easily choose their healthcare providers. Lessons learned for future research One of the challenges in completing a project like this was recognizing that the pace and scope of the research to be conducted would be fully dependent on the healthcare organization, and not the researcher. Unlike conducting a highly Notes 1. The providers were all allowed final editorial control over the soundbites that were utilized for presentation in these short videos. 1288 E. K. PERRAULT 2. The Spearman-Brown coefficient is provided as a measure of reliability for this two-item measure, as recommended by Eisinga, Te Grotenhuis, and Pelzer (2013). 3. About 15% of new patients surveyed after biographies were introduced indicated viewing them. An independent samples t-test was also conducted with biography viewing as the independent variable, and uncertainty as the dependent variable. The result showed a significant difference t (1962) = 3.49, p < .001, Cohen’s d = .23. Patients who viewed online biographies (n = 297; M = 3.18, SD = 1.56) reported less uncertainty than patients who did not (n = 1,667; M = 3.54, SD = 1.62). 4. About 7% of new patients surveyed after video biographies were introduced indicated viewing them. Hypothesis 2 is also tested by excluding patients who viewed videos prior to their consultations, but who ultimately visited providers who did not have videos present on the website (n = 3). The mean difference was greater, and again in the right direction – viewed videos (n = 66; M = 2.96, SD = 1.39), viewed text (n = 130; M = 3.19, SD = 1.64) – but was also non-significant t (194) = 0.98, p= .33. 5. Due to unequal variances (Levene’s test, F= 9.27, p =.002), a corrected t-statistic not assuming homogeneity of variances is reported with degrees of freedom adjusted from 2,324 to 482. Funding This work was partially supported by the Saremi Health & Wellness Foundation. ORCID Evan K. Perrault http://orcid.org/0000-0002-3227-1804 References Afifi, W. A., & Burgoon, J. K. (2000). The impact of violations on uncertainty and the consequences for attractiveness. Human Communication Research, 26, 203–233. doi:10.1111/hcre.2000.26. issue-2 Ambady, N., & Rosenthal, R. (1993). Half a minute: Predicting teacher evaluations from thin slices of nonverbal behavior and physical attractiveness. Journal of Personality and Social Psychology, 64, 431–441. doi:10.1037/0022-3514.64.3.431 Berger, C. R., & Calabrese, R. J. (1975). Some explorations in initial interaction and beyond: Toward a developmental theory of interpersonal communication. Human Communication Research, 1, 99–112. doi:10.1111/j.1468-2958.1975.tb00258.x Daft, R. L., & Lengel, R. H. (1984). Information richness: A new approach to managerial information processing and organization design. In B. Staw & L. Cummings (Eds.), Research in Organizational Behavior (pp. 191–233). Greenwich, CT: JAI Press. Davis, K., Schoenbaum, S. C., & Audet, A. M. (2005). A 2020 vision of patient-centered primary care. Journal of General Internal Medicine, 20, 953–957. doi:10.1111/j.1525-1497.2005.0178.x Eisinga, R., Te Grotenhuis, M., & Pelzer, B. (2013). The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown? International Journal of Public Health, 58, 637–642. doi:10.1007/ s00038-012-0416-3 Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9, 100–103. doi:10.1370/afm.1239 Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press. McCroskey, L. L., McCroskey, J. C., & Richmond, V. P. (2006). Analysis and improvement of the measurement of interpersonal attraction and homophily. Communication Quarterly, 54, 1–31. doi:10.1080/ 01463370500270322 Medical Web Experts. (2018). Medical video production. Retrieved from http://www.medicalwebexperts.com/blog/video-production/ Moran, J., Bekker, H., & Latchford, G. (2008). Everyday use of patient-centred, motivational techniques in routine consultations between doctors and patients with diabetes. Patient Education and Counseling, 73, 224–231. doi:10.1016/j.pec.2008.07.006 Parrott, R., & Steiner, C. (2003). Lessons learned about academic and public health collaborations in the conduct of community-based research. In T. L. Thompson, A. M. Dorsey, K. I. Miller, & R. Parrott (Eds.), Handbook of Health Communication (pp. 637–649). New York, NY: Routledge. Perrault, E. K. (2014). The content of family physicians’ online videos and biographies. Family Medicine, 46, 192–197. Perrault, E. K. (2018a). Adding multimedia cues to medical providers’ online biographies: Do pictures, video, and b-roll matter? Journal of Health Communication, 23, 462–469. doi:10.1080/10810730.2018.1465492 Perrault, E. K. (2018b). Campus health centers’ lack of information regarding providers: A content analysis of division-I campus health centers’ provider websites. Health Communication, 33, 860–866. doi:10.1080/10410236.2017.1316635 Perrault, E. K., & Hildenbrand, G. M. (2018). Primary care confusion: Public knowledge of NP and PA duties and their information gathering behaviors. Journal of General Internal Medicine, 33, 1857–1858. doi:10.1007/s11606-018-4580-x Perrault, E. K., & Silk, K. J. (2015). Reducing communication apprehension for new patients through information found within physicians’ biographies. Journal of Health Communication, 20, 743–750. doi:10.1080/10810730.2015.1018569 Perrault, E. K., & Silk, K. J. (2016). The uncertainty reducing capabilities of primary care physicians’ video biographies for choosing a new doctor: Is a video worth more than two hundred words? Health Communication, 31, 1472–1481. doi:10.1080/10410236.2015.1082457 Perrault, E. K., & Smreker, K. C. (2013). What can we learn from physicians’ online biographies to help in choosing a doctor? Not much. A content analysis of primary care physician biographies. Journal of Communication in Healthcare, 6, 122–127. doi:10.1179/ 1753807612Y.0000000027 Richmond, V. P., Smith, R. S., Heisel, A. M., & McCroskey, J. C. (1998). The impact of communication apprehension and fear of talking with a physician on perceived medical outcomes. Communication Research Reports, 15, 344–353. doi:10.1080/08824099809362133 Robinson, J. H., Callister, L. C., Berry, J. A., & Dearing, K. A. (2008). Patient-centered care and adherence: Definitions and applications to improve outcomes. Journal of the American Association of Nurse Practitioners, 20, 600–607. doi:10.1111/j.1745-7599.2008.00360.x Rogers, E. M., & Bhowmik, D. K. (1970). Homophily-heterophily: Relational concepts for communication research. The Public Opinion Quarterly, 34, 523–538. doi:10.1086/267838 Roghmann, K. J., Hengst, A., & Zastowny, T. R. (1979). Satisfaction with medical care: Its measurement and relation to utilization. Medical Care, 17, 461–479. Smith, J. A., Braunack-Mayer, A. J., Wittert, G. A., & Warin, M. J. (2008). Qualities men value when communicating with general practitioners: Implications for primary care settings. The Medical Journal of Australia, 189, 618–621. Stewart, M., Brown, J. B., Donner, A., McWhinney, I. R., Oates, J., Weston, W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. The Journal of Family Practice, 49, 796–804. Willes, K. L. (2018). Lesbian patients using online video profiles to find doctors: How cues inform the decision-making process (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (ProQuest No. 10815757). Zolnierek, K. B. H., & DiMatteo, M. R. (2009). Physician communication and patient adherence to treatment: A meta-analysis. Medical Care, 47, 826–834. doi:10.1097/MLR.0b013e31819a5acc
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