Child/Adolescent Health

The gender of both the child and parent affect a child's participation during visits to the doctor

When children and their parents actively participate in conversations with the pediatrician during visits, more information is exchanged and the pediatrician-patient relationship is enhanced. In addition, children who actively participate in their care tend to manage their chronic disease better and reduce their health care use. Participation during pediatrician visits appears to be influenced by the child's and the parent's gender, according to a new study.

For example, girls did twice as much relationship building as boys, and their physicians did 34 percent more information gathering. Also, having the father accompany the child reduced child relationship building 76 percent and reduced information imparted by the physician 14 percent compared to when the mother accompanied the child. This may be due to the mother's greater familiarity with the issues, since mothers are more likely to accompany children to physician visits. Whether the physician was the same gender as the parents or child had no significant effect on participation.

However, female doctors gave 29 percent less information to children and parents. After adjusting for the genders of all concerned, longer visits were associated with more participation of the physician, parent, and child. Since these gender-based patterns of participation in health care are evident in childhood, methods to facilitate participation in one's care might begin early in life.

Also, policies that support longer primary care visits could encourage parent participation, suggests Elizabeth D. Cox, M.D., Ph.D., of the University of Wisconsin School of Medicine and Public Health. Dr. Cox and colleagues analyzed videotapes and sociodemographics from 100 pediatric visits. Their study was supported by the Agency for Healthcare Research and Quality (HS13183).

See "Effect of gender and visit length on participation in pediatric visits," by Dr. Cox, Maureen A. Smith, M.D., M.P.H., Ph.D., Roger L. Brown, Ph.D., and Mary A. Fitzpatrick, in the March 2007 Patient Education and Counseling 65, pp. 320-328.

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