Factors Associated With Patient- and Family-Centered Care in the Hispanic Pediatric Population: A Secondary Analysis

Jared LeBron; Sarah Ronis

doi:10.1016/j.acap.2025.102828

Factors Associated With Patient- and Family-Centered Care in the Hispanic Pediatric Population: A Secondary Analysis

Acad Pediatr. 2025 Aug;25(6):102828. doi: 10.1016/j.acap.2025.102828. Epub 2025 Apr 8.

Authors

Jared LeBron¹, Sarah Ronis²

Affiliations

¹ Center for Child Health & Policy, UH Rainbow Babies and Children's Hospital (J. LeBron and S. Ronis), Cleveland, Ohio; University of South Florida Morsani College of Medicine (J. LeBron), Tampa, Fla. Electronic address: jared.lebron@uhhospitals.org.
² Center for Child Health & Policy, UH Rainbow Babies and Children's Hospital (J. LeBron and S. Ronis), Cleveland, Ohio; Department of Pediatrics, Case Western Reserve University School of Medicine (S. Ronis), Cleveland, Ohio. Electronic address: sarah.ronis@uhhospitals.org.

PMID: 40209921
DOI: 10.1016/j.acap.2025.102828

Abstract

Objective: Despite the documented benefits of patient- and family-centered care (PFCC), Hispanic children experience significantly lower rates of PFCC compared to non-Hispanic children. This study aimed to identify specific factors associated with the receipt of PFCC among Hispanic children.

Methods: Using data from the 2020-21 National Survey of Children's Health, cross-sectional secondary analyses were conducted to examine caregiver-reported clinician- and practice-level contributors to disparities in PFCC, specifically focusing on family-centered care (FCC) and shared decision-making (SDM) among US Hispanic versus non-Hispanic children and youth. Descriptive statistics were used to characterize social, demographic, and health care experiences. Stratified multivariable logistic regression analyses evaluated, among Hispanic children, associations of FCC/SDM with key covariates. All analyses were weighted to account for the complex survey design.

Results: Among 93,669 respondents (representing approximately 72.7 million noninstitutionalized US children and youth, 25.7% identifying as Hispanic or Latino), caregivers of Hispanic children were significantly less likely to report experiencing FCC and SDM if they had gaps in insurance coverage (FCC adjusted odds ratio [aOR] = 0.53, 95% Confidence Interval (CI): 0.37, 0.76; SDM aOR = 0.38, 95% CI: 0.18, 0.80) or lived in households where English was not the primary language (FCC aOR = 0.68, 95% CI: 0.52, 0.89; SDM aOR = 0.53, 95% CI: 0.33, 0.87). Additionally, not having a personal doctor was associated with lower odds of reporting FCC (aOR = 0.44, 95% CI: 0.34, 0.57).

Conclusions: A lack of stable relationships with personal doctors and limited availability of language-appropriate services were significantly associated with lower reports of PFCC and SDM among Hispanic children. These associations highlight potential targets for further research and quality improvement.

Keywords: Hispanic; patient- and family-centered care; pediatric; shared decision-making.

MeSH terms

Adolescent
Caregivers
Child
Child, Preschool
Cross-Sectional Studies
Decision Making, Shared*
Female
Healthcare Disparities* / ethnology
Hispanic or Latino* / statistics & numerical data
Humans
Infant
Insurance Coverage / statistics & numerical data
Logistic Models
Male
Patient-Centered Care* / statistics & numerical data
United States
White