Christy B Turer1, Sergio Montaño2, Hua Lin3, Kim Hoang4, Glenn Flores5. 1. 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. 2. School of Medicine, University of Texas Southwestern, Dallas, Texas; and. 3. Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; 4. School of Medicine, University of Texas Southwestern, Dallas, Texas; and Department of Pediatrics, Baylor College of Medicine, Houston, Texas. 5. Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; Children's Medical Center Dallas, Dallas, Texas;
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.
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: Sheri Volger; Marion L Vetter; Megan Dougherty; Eva Panigrahi; Rebecca Egner; Victoria Webb; J Graham Thomas; David B Sarwer; Thomas A Wadden Journal: Obesity (Silver Spring) Date: 2011-07-14 Impact factor: 5.002
Authors: Delia S West; James M Raczynski; Martha M Phillips; Zoran Bursac; C Heath Gauss; Brooke E E Montgomery Journal: Obesity (Silver Spring) Date: 2008-01-17 Impact factor: 5.002
Authors: Christy B Turer; Sarah E Barlow; David B Sarwer; Brian Adamson; Joanne Sanders; Chul Ahn; Song Zhang; Glenn Flores; Celette Sugg Skinner Journal: Am J Prev Med Date: 2019-08-01 Impact factor: 5.043