title: Audio-video recording of health care encounters for pediatric chronic conditions: observational reactivity and its correlates.
abstract: OBJECTIVE
  Audio-video recording of pediatric clinic visits could generate observational reactivity, affecting measures of communication among patients, parents, and clinicians.
  
  
  METHODS
  We measured observational reactivity in a direct observation study of communication during 155 pediatric visits for any of 5 chronic conditions by coding camcorder awareness behaviors and self-report questionnaires. We analyzed associations between observational reactivity and measures of communication behavior and visit quality.
  
  
  RESULTS
  Directly observed camcorder awareness behaviors (634 events) comprised 0.59% of all coded events (n = 107,668). Younger children displayed these behaviors more often than did older children (F = 6.47; p < .0001). Clinicians' camcorder awareness declined significantly over successive study visits (t = -2.096; p = .043). Associations of camcorder awareness with objectively scored communication behaviors or self-reported visit quality were negligible.
  
  
  CONCLUSIONS
  Most recordings included slight evidence of participant camcorder awareness. But there was negligible evidence that camcorder awareness influenced clinic visit communication.
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida hantal@nemours.org.
authors: Holly
authors: H
authors: Antal
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: M Jobayer
authors: MJ
authors: Hossain
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: Sandra
authors: S
authors: Hassink
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: Shannon
authors: S
authors: Henry
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: Lindsay
authors: L
authors: Fuzzell
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: Alex
authors: A
authors: Taylor
authors: Nemours, A Children's Health System, Jacksonville, Florida, Nemours, A Children's Health System, Wilmington, Delaware, and Nemours, A Children's Health System, Orlando, Florida.
authors: Tim
authors: T
authors: Wysocki
mesh_terms: D000293:Adolescent; D001364:Awareness; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D011446:Prospective Studies; D057566:Self Report; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014741:Video Recording
keywords: communication; direct observation; methodology; pediatrics