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Influence of race and socioeconomic statu... [Patient Educ Couns. 2012] - PubMed - NCBI

Patient Educ Couns. 2012 Jun;87(3):319-26. doi: 10.1016/j.pec.2011.09.012. Epub 2011 Nov 8.

Influence of race and socioeconomic status on engagement in pediatric primary care.

Cox ED, Nackers KA, Young HN, Moreno MA, Levy JF, Mangione-Smith RM.

Source

Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. ecox@wisc.edu

Abstract

OBJECTIVE:

To understand the association of race/ethnicity with engagement in pediatric primary care and examine how any racial/ethnic disparities are influenced by socioeconomic status.

METHODS:

Visit videos and parent surveys were obtained for 405 children who visited for respiratory infections. Family and physician engagement in key visit tasks (relationship building, information exchange, and decision making) were coded. Two parallel regression models adjusting for covariates and clustering by physician were constructed: (1) race/ethnicity only and (2) race/ethnicity with SES (education and income).

RESULTS:

With and without adjustment for SES, physicians seeing Asian families spoke 24% fewer relationship building utterances, compared to physicians seeing White, non-Latino families (p<0 .05=".05" 24="24" accounting="accounting" actively="actively" adjusting="adjusting" african="african" american="american" association.="association." be="be" but="but" compared="compared" decision="decision" engaged="engaged" families="families" for="for" gathered="gathered" in="in" information="information" latino="latino" less="less" likely="likely" making="making" mitigated="mitigated" mitigates="mitigates" non-latino="non-latino" p="p" ses="ses" significantly="significantly" similarly="similarly" than="than" this="this" to="to" were="were" white="white">

CONCLUSION:

While engagement during pediatric visits differed by the family's race/ethnicity, many of these differences were eliminated by accounting for socioeconomic status.

PRACTICE IMPLICATIONS:

Effective targeting and evaluation of interventions to reduce health disparities through improving engagement must extend beyond race/ethnicity to consider socioeconomic status more broadly.
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.