title: Effect of gender and visit length on participation in pediatric visits.
abstract: OBJECTIVE
  To examine the effect of child, physician and parent genders as well as visit length on participation.
  
  
  METHODS
  We analyzed videotapes and sociodemographics from 100 pediatric visits. Using the Roter Interaction Analysis System, coded utterances were aggregated to reflect key visit tasks: information giving, information gathering and relationship building. Negative binomial models were used to analyze how participation was associated with participants' genders and visit length.
  
  
  RESULTS
  After adjustment, girls did twice as much relationship building as boys (incidence rate ratio = 2.33, 95% confidence interval = 1.01-5.36) and their physicians did 34% more information gathering (1.34, 1.16-1.55). Female physicians did 29% less information giving (0.71, 0.54-0.94). Having the father accompany the child reduced child relationship building 76% (0.24, 0.08-0.69) and reduced physician information giving 14% (0.86, 0.75-0.995), compared to having mother accompany. After adjusting for participants' genders, longer visits were associated with more participation for all participants.
  
  
  CONCLUSIONS
  Child participation was impacted by child gender and by the accompanying parent's gender as well as the visit length.
  
  
  CONCLUSIONS
  Because gender-based patterns of participation are evident in childhood, interventions to facilitate participation might begin early in life. To improve participation, interventions might include advocating for policies to support longer visit lengths.
authors.affiliation: Center for Women's Health Research, University of Wisconsin School of Medicine and Public Health, WI, United States.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smith
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fitzpatrick
mesh_terms: D000293:Adolescent; D000328:Adult; D016010:Binomial Distribution; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D010372:Pediatrics / Q000379:methods*; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology; D010822:Physicians, Women / Q000523:psychology; D011368:Professional-Family Relations; D002666:Psychology, Child; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014743:Videotape Recording; D014922:Wisconsin