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Acad Pediatr. 2014 Jul-Aug;14(4):382-9. doi: 10.1016/j.acap.2014.03.002.

Which African American mothers disclose psychosocial issues to their pediatric providers?

Author information

1
Center for Translational Science, Children's National Medical Center, Washington, DC.
2
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md.
3
Center for Translational Science, Children's National Medical Center, Washington, DC. Electronic address: ihorn@cnmc.org.

Abstract

OBJECTIVE:

To determine if parents' self-efficacy in communicating with their child's pediatrician is associated with African American mothers' disclosure of psychosocial concerns during pediatric primary care visits.

METHODS:

Self-identified African American mothers (n = 231) of children 2 to 5 years were recruited from 8 urban pediatric primary care practices in the Washington, DC, metropolitan area. Visits were audiorecorded, and parents completed phone surveys within 24 hours. Maternal disclosure of psychosocial issues and self-efficacy in communicating with their child's provider were measured using the Roter Interactional Analysis System (RIAS) and the Perceived Efficacy in Patient-Physician Interactions (PEPPI), respectively.

RESULTS:

Thirty-two percent of mothers disclosed psychosocial issues. Mothers who disclosed were more likely to report maximum levels of self-efficacy in communicating with their child's provider compared to those who did not disclose (50% vs 35%; P = .02). During visits in which mothers disclosed psychosocial issues, providers were observed to provide more psychosocial information (mean 1.52 vs 1.08 utterances per minute, P = .002) and ask fewer medical questions (mean 1.76 vs 1.99 utterances per minute, P = .05) than during visits in which mothers did not disclose. The association between self-efficacy and disclosure was significant among low-income mothers (odds ratio 5.62, P < .01), but not higher-income mothers.

CONCLUSIONS:

Findings suggest that efforts to increase parental self-efficacy in communicating with their child's pediatrician may increase parents' likelihood of disclosing psychosocial concerns. Such efforts may enhance rates of identifying and addressing psychosocial issues, particularly among lower-income African American patients.

KEYWORDS:

African American; childhood mental health; parent–provider communication; primary care

PMID:
24976350
PMCID:
PMC4111561
DOI:
10.1016/j.acap.2014.03.002
[Indexed for MEDLINE]
Free PMC Article

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