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J Asthma. 2018 Apr;55(4):424-429. doi: 10.1080/02770903.2017.1337790. Epub 2017 Jul 14.

Racial disparities in family-provider interactions for pediatric asthma care.

Author information

1
a Division of Pediatric Pulmonology and Quantitative Health Sciences , University of Massachusetts Medical School , Worcester , MA , USA.
2
b Mongan Institute for Health Policy , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA.
3
c Health Partners Institute , Minneapolis , MN , USA.
4
d Vanderbilt University School of Medicine , Nashville , TN , USA.
5
e Center for Clinical Outcomes & Research - Southeast , Kaiser Permanente Georgia , Atlanta , GA , USA.
6
f Roivant Sciences , Hamilton , Bermuda.
7
g Center for Healthcare Research in Pediatrics, Department of Population Medicine , Harvard Pilgrim Health Care Institute and Harvard Medical School , Boston , MA , USA.
8
h Division of Research , Kaiser Permanente Northern California , Oakland , CA , USA.

Abstract

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.

KEYWORDS:

Children; disparity; lung disease; race; treatment plan

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