Parent Race and Communication During Elective Pediatric Surgery Consultations

Area of Science:

• Health Services Research
• Pediatric Surgery
• Health Communication

Background:

• Marginalized racial groups, including children and adolescents, face poorer surgical outcomes compared to White counterparts.
• Clinical communication is a potential contributing factor to these health disparities in pediatric surgical care.

Purpose of the Study:

• To investigate racial disparities in communication between parents and clinicians during initial consultations for pediatric elective surgical procedures.
• To identify specific communication patterns associated with race in pediatric surgical consultations.

Main Methods:

• A cohort study involving audio-recorded consultations between surgical clinicians and parents of children (ages 2-17) undergoing common procedures.
• Utilized the Roter Interaction Analysis System to quantify communication variables, including verbal dominance, patient-centeredness, and affective statements.
• Employed generalized estimating equations to analyze associations 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, even after adjustments.
• Black parents' visits were characterized by fewer clinician chitchat statements and lower overall parent engagement (fewer total statements, emotional statements, and chitchat).
• While patient-centeredness scores did not differ overall, Black parents exhibited lower positive affect during consultations.

Conclusions:

• Parent race is associated with distinct patterns in clinician, parent, and interactive communication during pediatric surgical consultations.
• Differences in communication, particularly parent engagement, may be influenced by sociodemographic factors but also indicate a need for improved communication strategies.
• Implementing patient-centered communication and engagement strategies is crucial for mitigating social distance and improving equity in pediatric surgical care.