Racial disparities in family-provider interactions for pediatric asthma care

J Asthma. 2018 Apr;55(4):424-429. doi: 10.1080/02770903.2017.1337790. Epub 2017 Jul 14.

Abstract

Objective: Black and Latino children experience significantly worse asthma morbidity than their white peers for multifactorial reasons. This study investigated differences in family-provider interactions for pediatric asthma, based on race/ethnicity.

Methods: This was a cross-sectional study of parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. Our study population comprised 647 parents with survey response data. Data on self-reported race/ethnicity of the child were collected from parents of the children with asthma. Outcomes studied were responses to the questions about family-provider interactions in the previous 12 months: (1) number of visits with asthma provider; (2) number of times provider reviewed asthma medications with patient/family; (3) review of a written asthma treatment plan with provider; and (4) preferences about making asthma decisions.

Results: In multivariate adjusted analyses controlling for asthma control and other co-morbidities, black children had fewer visits in the previous 12 months for asthma than white children: OR 0.63 (95% CI 0.40, 0.99). Additionally, black children were less likely to have a written asthma treatment plan given/reviewed by a provider than their white peers, OR 0.44 (95% CI 0.26, 0.75). There were no significant differences by race in preferences about asthma decision-making nor in the frequency of asthma medication review.

Conclusion: Black children with asthma have fewer visits with their providers and are less likely to have a written asthma treatment plan than white children. Asthma providers could focus on improving these specific family-provider interactions in minority children.

Keywords: Children; disparity; lung disease; race; treatment plan.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy
  • Asthma / ethnology*
  • Child
  • Child, Preschool
  • Female
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Medication Reconciliation
  • Office Visits / statistics & numerical data*
  • Parents
  • Patient Satisfaction
  • Physicians, Family / statistics & numerical data*
  • Racial Groups / statistics & numerical data*
  • Surveys and Questionnaires

Substances

  • Anti-Asthmatic Agents