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Racial disparities in family-provider interactions for pediatric asthma care
Michelle Trivedi1, Vicki Fung2, Elyse O Kharbanda3
1a Division of Pediatric Pulmonology and Quantitative Health Sciences , University of Massachusetts Medical School , Worcester , MA , USA.
Insights
Black children with asthma have fewer provider visits and written treatment plans compared to white children. Improving these interactions is key for better pediatric asthma care in minority populations.
Area of Science:
- Pediatric Pulmonology
- Health Disparities Research
- Family Medicine
Background:
- Asthma morbidity disproportionately affects Black and Latino children.
- Multifactorial reasons contribute to these health disparities.
- Understanding family-provider interactions is crucial for addressing these inequities.
Purpose of the Study:
- To investigate racial and ethnic differences in family-provider interactions for pediatric asthma care.
- To identify specific areas where communication and care can be improved for minority children with asthma.
Main Methods:
- Cross-sectional study utilizing parent surveys from the Population-Based Effectiveness in Asthma and Lung Diseases Network.
- Included 647 parents of children with asthma, collecting data on child's race/ethnicity.
- Assessed family-provider interactions including visit frequency, medication review, treatment plan review, and decision-making preferences.
Main Results:
- Black children had significantly fewer asthma-related provider visits than white children (OR 0.63).
- Black children were less likely to receive or review a written asthma treatment plan with a provider (OR 0.44).
- No significant racial differences were observed in asthma medication review frequency or decision-making preferences.
Conclusions:
- Black children with asthma experience fewer provider visits and less frequent review of written treatment plans compared to white children.
- Healthcare providers should focus on enhancing these specific interactions for minority children.
- Targeted interventions may improve asthma management and reduce morbidity in underserved pediatric populations.
Objective:
Black and Latino children experience significantly worse asthma morbidity than their white peers for multifactorial reasons. This study investigated differences in family-provider interactions for pediatric asthma, based on race/ethnicity.
Methods:
This was a cross-sectional study of parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. Our study population comprised 647 parents with survey response data. Data on self-reported race/ethnicity of the child were collected from parents of the children with asthma. Outcomes studied were responses to the questions about family-provider interactions in the previous 12 months: (1) number of visits with asthma provider; (2) number of times provider reviewed asthma medications with patient/family; (3) review of a written asthma treatment plan with provider; and (4) preferences about making asthma decisions.
Results:
In multivariate adjusted analyses controlling for asthma control and other co-morbidities, black children had fewer visits in the previous 12 months for asthma than white children: OR 0.63 (95% CI 0.40, 0.99). Additionally, black children were less likely to have a written asthma treatment plan given/reviewed by a provider than their white peers, OR 0.44 (95% CI 0.26, 0.75). There were no significant differences by race in preferences about asthma decision-making nor in the frequency of asthma medication review.
Conclusion:
Black children with asthma have fewer visits with their providers and are less likely to have a written asthma treatment plan than white children. Asthma providers could focus on improving these specific family-provider interactions in minority children.
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