Learning to participate: effect of child age and parental education on participation in pediatric visits.
Children's participation in health care improves outcomes, yet little is known about factors that affect participation. We examine how child age and parental education affect participation. Visit videotapes were coded to reflect key visit tasks: information giving, information gathering, and relationship building. Multivariable models were used to analyze how participation was associated with child age and parental education. For each year of child age, physicians did 3% more information gathering, incidence rate ratio (IRR) = 1.03, 95% confidence interval (95% CI) = 1.01-1.06, but reduced relationship building by 4%, IRR = 0.96, 95% CI = 0.94-0.97. Children of college-graduate parents spoke twice as much information-giving talk, IRR = 2.11, 95% CI = 1.07-4.17, and nearly 5 times as much relationship-building talk, IRR = 4.74, 95% CI = 1.45-15.52, as children with less educated parents. Results suggest physicians might attend to relationship building with older children and work to improve participation of children of less educated parents.
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, H4/444 Clinical Science Center, 600 Highland Avenue, Madison,WI 53715-6423, USA. ecox@wisc.edu
Elizabeth D
ED
Cox
Maureen A
MA
Smith
Roger L
RL
Brown
Mary A
MA
Fitzpatrick
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents; D010353:Patient Education as Topic / Q000458:organization & administration*; D010358:Patient Participation; D010372:Pediatrics; D010817:Physician-Patient Relations; D014743:Videotape Recording