Parent Race and Communication During Elective Pediatric Surgery Consultations

Area of Science:

• Pediatric Surgery
• Health Disparities
• Clinical Communication

Background:

• Children from marginalized racial groups often face worse surgical outcomes than White children.
• Clinical communication patterns may exacerbate these racial disparities in healthcare.

Purpose of the Study:

• To investigate racial differences in parent-clinician communication during initial consultations for pediatric elective surgeries.
• To identify specific communication behaviors associated with parent race.

Main Methods:

• A cross-sectional study analyzed audio recordings of 153 parent-clinician dyads during consultations for common pediatric surgeries.
• Communication was coded using the Roter Interaction Analysis System (RIAS) to measure verbal dominance, patient-centeredness, and affective communication.
• Generalized estimating equations were used to assess the association between parent race and communication outcomes, adjusting for sociodemographic factors.

Main Results:

• Visits involving Black parents showed significantly higher clinician verbal dominance compared to visits with White parents.
• Black parents made fewer statements overall and exhibited lower positive affect during consultations.
• While some differences were mediated by sociodemographic factors, clinician dominance persisted after adjustment.

Conclusions:

• Parent race is associated with distinct patterns of communication in pediatric surgical consultations.
• Differences were observed in clinician, parent, and interactive communication, with parent communication playing a significant role.
• Implementing patient-centered communication strategies may help reduce social distance and improve equity in pediatric surgical care.