108 - Language Disparities in Satisfaction with Physician Communication Among Caregivers of Children From 2 Months to 2 Years

Poster Number: 108
Publication Number: 108.212

Jennifer C. Gutierrez-Wu, University of North Carolina at Chapel Hill School of Medicine, durham, NC, United States; Victor Ritter, University of North Carolina at Chapel Hill School of Medicine, Durham, NC, United States; Alan M. Delamater, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States; William Heerman, Vanderbilt University Medical Center, Nashville, TN, United States; Eliana M. Perrin, Johns Hopkins School of Medicine, Baltimore, MD, United States; Russell Rothman, Vanderbilt University Medical Center, Nashville, TN, United States; Lee Sanders, Stanford University, Stanford, CA, United States; H. Shonna Yin, NYU Grossman School of Medicine, New York City, NY, United States; Kori Flower, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States

Background: Spanish-speaking caregivers report less satisfaction with physician communication than English-speaking caregivers. No published reports have described how caregiver satisfaction with physician communication changes during frequent well child visit during early childhood, or how satisfaction over time may differ by primary language spoken.

Objective: This study aimed to describe caregiver satisfaction with physician communication over the first 2 years of life, and to examine whether and how this differs between Spanish and English-speaking caregivers.

Design/Methods: This is a secondary analysis of a longitudinal randomized controlled trial to prevent early childhood obesity. Satisfaction with communication was assessed using the Communication Assessment Tool (CAT), a validated 15-item questionnaire. Scores ranged from 1-5 and were dichotomized as optimal (5) or suboptimal ( < 5). Changes in the odds of optimal scores were estimated using a mixed-effects logistic regression adjusting for study site, and parent age, education level, and health literacy. Adjusted predicted probabilities of optimal scores by language over time were also calculated.

Results: Of 865 caregivers, 35% were Spanish-speaking and most had annual incomes < $40,000. In adjusted analyses Spanish-speaking caregivers had 0.62 (95% CI 0.43,0.91) times the odds of optimal communication satisfaction compared to English-speakers. The proportion of optimal scores increased over time for both language groups, and the difference between the 2 groups narrowed over time (Figure 1). The rate of change in the odds of optimal scores for Spanish-speakers is 1.02 (95% CI 1.00, 1.05) times that of English-speakers, and increased by 2% (95% CI 1%, 4%) and 4% (95% CI 1%, 9%) monthly for English and Spanish-speakers, respectively (Table 1). Conclusion(s): While Spanish-speaking caregivers reported less satisfaction with physician communication than English-speaking caregivers, this disparity narrowed over the first 2 years of childhood. Improvements may be due to increased provider continuity as caregiver-provider trust is built or as caregivers accrue health care knowledge. Additional studies are needed to understand why Spanish-speakers report less satisfaction as well as what contributes to increased satisfaction, to guide initiatives to ameliorate early communication satisfaction disparities.
CV Jennifer_Gutierrez-Wu_1.22.pdf
Figure 1. Adjusted Predicted Probabilities of Optimal Communication Assessment Tool Scores for English and Spanish-speaking Caregivers Over Time