title: Which African American mothers disclose psychosocial issues to their pediatric providers?
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.
authors: Center for Translational Science, Children's National Medical Center, Washington, DC.
authors: Leandra
authors: L
authors: Godoy
authors: Center for Translational Science, Children's National Medical Center, Washington, DC.
authors: Stephanie J
authors: SJ
authors: Mitchell
authors: Center for Translational Science, Children's National Medical Center, Washington, DC.
authors: Kanya
authors: K
authors: Shabazz
authors: Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md.
authors: Larry S
authors: LS
authors: Wissow
authors: Center for Translational Science, Children's National Medical Center, Washington, DC. Electronic address: ihorn@cnmc.org.
authors: Ivor B
authors: IB
authors: Horn
mesh_terms: D000328:Adult; D001741:Black or African American; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D010372:Pediatrics; D011203:Poverty; D011320:Primary Health Care; D011368:Professional-Family Relations; D012650:Self Disclosure; D020377:Self Efficacy
keywords: African American; childhood mental health; parent–provider communication; primary care