Audio-video recording of health care encounters for pediatric chronic conditions: observational reactivity and its correlates

J Pediatr Psychol. 2015 Jan-Feb;40(1):144-53. doi: 10.1093/jpepsy/jsu046. Epub 2014 Jun 28.


Objectives: Audio-video recording of pediatric clinic visits could generate observational reactivity, affecting measures of communication among patients, parents, and clinicians.

Methods: We measured observational reactivity in a direct observation study of communication during 155 pediatric visits for any of 5 chronic conditions by coding camcorder awareness behaviors and self-report questionnaires. We analyzed associations between observational reactivity and measures of communication behavior and visit quality.

Results: Directly observed camcorder awareness behaviors (634 events) comprised 0.59% of all coded events (n = 107,668). Younger children displayed these behaviors more often than did older children (F = 6.47; p < .0001). Clinicians' camcorder awareness declined significantly over successive study visits (t = -2.096; p = .043). Associations of camcorder awareness with objectively scored communication behaviors or self-reported visit quality were negligible.

Conclusions: Most recordings included slight evidence of participant camcorder awareness. But there was negligible evidence that camcorder awareness influenced clinic visit communication.

Keywords: communication; direct observation; methodology; pediatrics.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Awareness*
  • Child
  • Child, Preschool
  • Chronic Disease / psychology*
  • Communication*
  • Female
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care
  • Physician-Patient Relations*
  • Professional-Family Relations*
  • Prospective Studies
  • Self Report
  • Statistics as Topic
  • Surveys and Questionnaires
  • Video Recording*