title: Relationship between Teach-back and patient-centered communication in primary care pediatric encounters.
abstract: OBJECTIVE
  We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter.
  
  
  METHODS
  Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness.
  
  
  RESULTS
  Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p=0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI)=4.97 (4.47-5.53)]and negative affect [AOR (95% CI)=5.39 (1.68-17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it.
  
  
  CONCLUSIONS
  Teach-back was associated with more patient-centered communication and increased affective engagement of parents.
  
  
  CONCLUSIONS
  Standardizing Teach-back use may strengthen patient-centered communication.
authors.affiliation: Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Badaczewski
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, NY, USA.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Bauman
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, NY, USA.
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Blank
authors.affiliation: New York University School of Medicine, New York, NY, USA.
authors.forename: Benard
authors.initials: B
authors.lastname: Dreyer
authors.affiliation: Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Abrams
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, NY, USA.
authors.forename: Ruth E K
authors.initials: REK
authors.lastname: Stein
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.affiliation: Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: Jobayer
authors.initials: J
authors.lastname: Hossain
authors.affiliation: Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; The Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Hal
authors.initials: H
authors.lastname: Byck
authors.affiliation: Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; The Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: iman.sharif@nyumc.org.
authors.forename: Iman
authors.initials: I
authors.lastname: Sharif
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D003691:Delaware; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D010290:Parents; D018802:Patient-Centered Care / Q000379:methods*; D010372:Pediatrics; D010817:Physician-Patient Relations; D013637:Tape Recording; D064871:Teach-Back Communication
keywords: Communication; Global affect; Patient-centered; Teach-back