Effect of gender and visit length on participation in pediatric visits

Abstract

Objective: To examine the effect of child, physician and parent genders as well as visit length on participation.

Methods: We analyzed videotapes and sociodemographics from 100 pediatric visits. Using the Roter Interaction Analysis System, coded utterances were aggregated to reflect key visit tasks: information giving, information gathering and relationship building. Negative binomial models were used to analyze how participation was associated with participants' genders and visit length.

Results: After adjustment, girls did twice as much relationship building as boys (incidence rate ratio = 2.33, 95% confidence interval = 1.01-5.36) and their physicians did 34% more information gathering (1.34, 1.16-1.55). Female physicians did 29% less information giving (0.71, 0.54-0.94). Having the father accompany the child reduced child relationship building 76% (0.24, 0.08-0.69) and reduced physician information giving 14% (0.86, 0.75-0.995), compared to having mother accompany. After adjusting for participants' genders, longer visits were associated with more participation for all participants.

Conclusion: Child participation was impacted by child gender and by the accompanying parent's gender as well as the visit length.

Practice implications: Because gender-based patterns of participation are evident in childhood, interventions to facilitate participation might begin early in life. To improve participation, interventions might include advocating for policies to support longer visit lengths.