The Annals of Family Medicine encourages readers to develop a learning community to improve health care and health through enhanced primary care. Participate by conducting a journal club. We encourage diverse participants to think critically about important issues affecting primary care and act on those discussions.1
HOW IT WORKS
In each issue, the Annals selects an article and provides discussion tips and questions. Post a summary of your conversation in our online discussion. (Open the article, click on the eLetters tab, and submit a comment.) Discussion questions and information are online at: https://www.AnnFamMed.org/content/AJC.
CURRENT SELECTION
Bazargan M, Cobb S, Assari S. Discrimination and medical mistrust in a racially and ethnically diverse sample of California adults. Ann Fam Med. 2021;19(1):4-15.
Discussion Tips
A better understanding of how individuals of different racial and ethnic backgrounds experience and view the medical care system could impact the health of a population. A better causal model that accounts for these perceptions might allow for better design of care systems and a greater appreciation of these perceptions might affect how individual clinicians interact with patients.
Discussion Questions
What question is asked by this study and why does it matter?
How does this study advance beyond previous research on this topic?
How strong is the study design for answering the question?
o. What are the benefits and weaknesses of the survey design and administration?
o. What are the potential biases created by the survey design?
o. What confounding variables are present within the study?
▪ What is the difference between a moderator and a mediator? Which of these should be controlled for in a regression analysis?
▪ What is endogeneity? What happens to a model if there is endogeneity built into a model?
o. What type of model did the author’s use? What are the assumptions of a multinomial logistic regression? What’s the difference between ordinal and multinomial logistic regressions?
To what degree can the findings be accounted for by:
o. How the main outcome variables were measured?
What findings do you notice in the bivariate analyses (Table 3)? How do these compare to the multivariable model?
o. Do you think reporting having a primary care physician is a cause and/or effect of medical mistrust? How might this impact our causal model?
o. What’s the difference between a point estimate and a confidence interval?
How comparable is the study sample to similar patients in your practice? What is your judgment about the transportability of the findings?
What contextual factors are important for interpreting the findings?
o. How would you gauge the potential benefits and harms of the study?
How might this study change your practice? Education? Research?
Who are the constituencies for the findings, and how they might be engaged in interpreting or using the findings?
What are the next steps in interpreting or applying the findings?
What researchable questions remain?
- © 2021 Annals of Family Medicine, Inc.
References
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