Which African American mothers disclose psychosocial issues to their pediatric providers?

Acad Pediatr. 2014 Jul-Aug;14(4):382-9. doi: 10.1016/j.acap.2014.03.002.


Objective: To determine if parents' self-efficacy in communicating with their child's pediatrician is associated with African American mothers' disclosure of psychosocial concerns during pediatric primary care visits.

Methods: Self-identified African American mothers (n = 231) of children 2 to 5 years were recruited from 8 urban pediatric primary care practices in the Washington, DC, metropolitan area. Visits were audiorecorded, and parents completed phone surveys within 24 hours. Maternal disclosure of psychosocial issues and self-efficacy in communicating with their child's provider were measured using the Roter Interactional Analysis System (RIAS) and the Perceived Efficacy in Patient-Physician Interactions (PEPPI), respectively.

Results: Thirty-two percent of mothers disclosed psychosocial issues. Mothers who disclosed were more likely to report maximum levels of self-efficacy in communicating with their child's provider compared to those who did not disclose (50% vs 35%; P = .02). During visits in which mothers disclosed psychosocial issues, providers were observed to provide more psychosocial information (mean 1.52 vs 1.08 utterances per minute, P = .002) and ask fewer medical questions (mean 1.76 vs 1.99 utterances per minute, P = .05) than during visits in which mothers did not disclose. The association between self-efficacy and disclosure was significant among low-income mothers (odds ratio 5.62, P < .01), but not higher-income mothers.

Conclusions: Findings suggest that efforts to increase parental self-efficacy in communicating with their child's pediatrician may increase parents' likelihood of disclosing psychosocial concerns. Such efforts may enhance rates of identifying and addressing psychosocial issues, particularly among lower-income African American patients.

Keywords: African American; childhood mental health; parent–provider communication; primary care.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black or African American
  • Child, Preschool
  • Cross-Sectional Studies
  • District of Columbia
  • Female
  • Humans
  • Logistic Models
  • Mothers / psychology*
  • Pediatrics
  • Poverty
  • Primary Health Care
  • Professional-Family Relations*
  • Self Disclosure*
  • Self Efficacy