Article: Health Literacy and Control in the Medical Encounter: A Mixed-Methods Analysis

Financial Support: This work was supported by a Pfizer Health Literacy Scholar Award, a K12 grant from the NIH National Center for Research Resources (K12 RR017643), and a K23 Mentored Patient-Oriented Research Career Development Award (K23 HL077597) to Dr Kripalani.

Background: Physician-patient communication can be described according to 4 prototypes of control-paternalism, mutuality, consumerism, or default. Patients with inadequate health literacy skills may be less-active participants in their care and more likely to have paternalistic encounters.

Methods: Two independent coders analyzed 31 transcribed outpatient medical visits between physicians and African American patients with ...

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