title: Pediatricians' communication about weight with overweight Latino children and their parents.
abstract: OBJECTIVE
  To examine pediatrician weight-management communication with overweight Latino children and their parents and whether communication differs by pediatrician-patient language congruency.
  
  
  METHODS
  Mixed-methods analysis of video-recorded primary care visits with overweight 6- to 12-year-old children. Three independent reviewers used video/transcript data to identify American Academy of Pediatrics-recommended communication content and establish communication themes/subthemes. Language incongruence (LI) was defined as pediatrician limited Spanish proficiency combined with parent limited English proficiency (LEP). Bivariate analyses examined associations of LI with communication content/themes.
  
  
  RESULTS
  The mean child age (N = 26) was 9.5 years old; 81% were obese. Sixty-two percent of parents had LEP. Twenty-seven percent of pediatricians were Spanish-proficient. An interpreter was used in 25% of LI visits. Major themes for how pediatricians communicate overweight included BMI, weight, obese, chubby, and no communication (which only occurred in LI visits). The pediatrician communicated child overweight in 81% of visits, a weight-management plan in 50%, a culturally relevant dietary recommendation in 42%, a recommendation for a follow-up visit in 65%, and nutrition referral in 50%. Growth charts were used in 62% of visits but significantly less often in LI (13%) versus language-congruent (83%) visits (P < .001).
  
  
  CONCLUSIONS
  Many overweight Latino children do not receive direct communication of overweight, culturally sensitive dietary advice, or follow-up visits. LI is associated with a lower likelihood of growth chart use. During primary care visits with overweight Latino children, special attention should be paid to directly communicating child overweight, formulating culturally sensitive weight-management plans, and follow-up. With LEP families, vigilance is needed in providing a trained interpreter and using growth charts.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; Children's Medical Center Dallas, Dallas, Texas; christy.turer@utsouthwestern.edu.
authors.forename: Christy B
authors.initials: CB
authors.lastname: Turer
authors.affiliation: School of Medicine, University of Texas Southwestern, Dallas, Texas; and.
authors.forename: Sergio
authors.initials: S
authors.lastname: Montaño
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Hua
authors.initials: H
authors.lastname: Lin
authors.affiliation: School of Medicine, University of Texas Southwestern, Dallas, Texas; and Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Kim
authors.initials: K
authors.lastname: Hoang
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; Children's Medical Center Dallas, Dallas, Texas;
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
mesh_terms: D001835:Body Weight / Q000208:ethnology*; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D050177:Overweight / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D010290:Parents; D010372:Pediatrics / Q000379:methods*; D010817:Physician-Patient Relations
keywords: Latino health; childhood obesity; communication; primary care