Patient rating of provider communication was assessed with a measure adapted from a study
of the effect of physician communication style on beliefs and medication-taking behaviors
of patients with depression (3). This scale assesses the extent to which patients felt the
provider encouraged their participation in treatment decisions and monitored their
medication use. In the original 13-item scale, 2 items required categorical (yes/no) responses
and ask whether the patient was given written information about the medication and if a
follow-up appointment was scheduled. Given that different metrics (e.g., categorical) were
Schoenthaler et al. Page 3
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used for these items, they were dropped to form an 11-item scale for this study. Responses
for the first eleven questions range from 1 = not at all to 4 = very much. Individual items are
summed to form a total continuous score (range: 11–44), with higher scores signifying more
collaborative communication. Sample questions include “To what degree is your doctor: 1)
friendly during the visit, and 2) asking about your concerns. Responses were scored from
not at all to very much. Because scores were substantially negatively skewed, the scale was
reverse-scored and then log transformed prior to data analysis. As a result, lower scores on
the log-transformed scale are indicative of more collaborative communication, and the
parameter estimates in the regression models indicate the amount of adherence for a 1-unit
change on the log-transformed poor communication scale (range: 1 – 4). The properties of
the 11-item measure were reevaluated and found to be satisfactory with a Cronbach alpha of
0.92 in our sample compared to an alpha of 0.84 reported by Bultman and Svarstad.