The Presence 5 for Racial Justice Framework for Anti-Racist Communication with Black Patients. Health services research Brown-Johnson, C., Cox, J., Shankar, M., Baratta, J., De Leon, G., Garcia, R., Hollis, T., Verano, M., Henderson, K., Upchurch, M., Safaeinili, N., Shaw, J. G., Fortuna, R. J., Beverly, C., Walsh, M., Somerville, C. S., Haverfield, M., Israni, S. T., Verghese, A., Zulman, D. M. 2022


To identify communication practices that clinicians can use to address racism faced by Black patients, build trusting relationships, and empower Black individuals in clinical care.Qualitative data (N=112 participants, August 2020 to March 2021) collected in partnership with clinics primarily serving Black patients in Leeds, AL; Memphis, TN; Oakland, CA; and Rochester, NY.This multi-phased project was informed by human-centered design thinking and community-based participatory research principles. We mapped emergent communication and trust-building strategies to domains from the Presence 5 framework for fostering meaningful connection in clinical care.Interviews and focus group discussions explored anti-racist communication and patient-clinician trust (n=36 Black patients; n=40 non-medical professionals and n=24 clinicians of various races and ethnicities). The Presence 5 Virtual National Community Advisory Board guided analysis interpretation.The emergent Presence 5 for Racial Justice (P5RJ) practices include: 1) Prepare with intention by reflecting on identity, bias, and power dynamics; and creating structures to address bias and structural determinants of health; 2) Listen intently and completely without interruption and listen deeply for the potential impact of anti-Black racism on patient health and interactions with healthcare; 3) Agree on what matters most by having explicit conversations about patient goals, treatment comfort and consent, and referral planning; 4) Connect with the patient's story, acknowledging socioeconomic factors influencing patient health and focusing on positive efforts; 5) Explore emotional cues by noticing and naming patient emotions, and considering how experiences with racism might influence emotions.P5RJ provides a framework with actionable communication practices to address pervasive racism experienced by Black patients. Effective implementation necessitates clinician self-reflection, personal commitment, and institutional support that offers time and resources to elicit a patient's story and to address their needs.

View details for DOI 10.1111/1475-6773.14015

View details for PubMedID 35765147