Patient-centred communication and provider avoidance: Does body mass index modify the relationship?

Objective: Poor quality communication with healthcare providers has been associated with provider avoidance. Because obesity is stigmatised in healthcare settings, this association may differ for patients who are overweight or obese compared to patients who are normal weight. Our objective was to determine if associations between patient-centred communication and provider avoidance differed by body mass index (BMI) category. Methods: We used data from the Health Information National Trends Survey 3, a cross-sectional data set that is nationally representative of the USA. We examined adjusted associations between patient-centred communication (measured using a six-item scale) and healthcare provider avoidance, stratified by BMI category (normal weight, overweight or obese). Results: The association between patient-centred communication and provider avoidance was similar in normal weight (adjusted odds ratios [AOR]=.65; 95% CI, .51-.83), overweight (AOR=.69; 95% CI, .55-.86) and obese (AOR=.55; 95% CI, .43-.70) subgroups. Across all three BMI categories, higher levels of patient-centred communication were significantly associated with lower odds of provider avoidance. Conclusion: This study highlights the importance of patient-centred communication for good-quality healthcare and for patients' healthcare decisions, regardless of patient characteristics such as BMI. Patient-centred communication can positively impact healthcare seeking for diverse groups, even those who may experience stigma and discrimination in healthcare.