Date of Award

Summer 2023

Document Type

Open Access Thesis

Department

Psychology

First Advisor

Guillermo M. Wippold

Abstract

Black Americans continue to embody strength and resilience in the face of systemic racism and oppression. However, as health disparities experienced by Black Americans continue to widen, it cannot be expected that they be solely responsible to leverage cultural strengths to improve health and well-being in the face of systemic injustice. Instead, it is equally as important to consider the wealth of opportunities that exist for systems, organizations, and policies to dismantle barriers to health and well-being experienced by Black Americans. Therefore, the present study examined the moderating role of patient-centered culturally sensitive health care (PC-CSHC) on the relationship between health self-efficacy (HSE) and patient engagement (PE) among Black American adults. A sample of 198 Black American adults participated in this study, which consisted of an online survey administered via Amazon Mechanical Turk. It was hypothesized that PC-CSHC imparted by 1) health care providers, 2) front office staff, and 3) the health care center office environment would buffer against the adverse effects of low HSE on PE. Results revealed that although PC-CSHC imparted by providers, front office staff, and the health care center office environment were statistically significant predictors of PE, the hypotheses of this study were not supported as PC-CSHC imparted by health care providers, front office staff, and the health care center office environment were not statistically significant moderators of the relationship between HSE and PE. Additional analyses revealed that PC-CSHC imparted by health care providers was comparable to HSE as a predictor of patient engagement, suggesting that provider PC-CSHC (an interpersonal level of the ecological model of health) is estimated to promote PE as well as HSE (an intrapersonal level of the ecological model of health). Thus, the results of this study challenge traditional health promotion paradigms that health is best promoted with factors most proximal to the individual; instead, the results of this study call for the addition of systems-level interventions – such as the provision of PC-CSHC – to address health disparities experienced by Black Americans.

Rights

© 2023, Kaylyn Ann Garcia

Available for download on Wednesday, March 11, 2026

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