550 - Parent perceptions of primary care, interpersonal communication, and trust in providers by parent race, ethnicity, and payer

Poster Number: 550
Publication Number: 550.118

Courtney Judkins, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Emilie H.. Delestienne, Kids Plus Pediatrics and The Breastfeeding Center of Pittsburgh, Pittsburgh, PA, United States; Barbara Fuhrman, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Elizabeth .. Miller, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States; Kristin Ray, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

Background: In the United States, disparities in receipt and quality of healthcare services are pervasive. To promote equitable health systems that provide high-quality services to all, we must examine the processes and experiences of patients as they receive care.

Objective: We aim to assess how parent race and ethnicity, parent employment, and child health insurance are associated with parental perceptions of access to care, trust in providers, and interpersonal processes of care amongst pediatric patients in Allegheny County, Pennsylvania.

Design/Methods: This study used electronic survey data from The Pittsburgh Study conducted in Allegheny County, Pennsylvania. Parents of infants were recruited from birth hospitals, primary care practices, and WIC offices; adolescents and their parents were recruited from schools. We analyzed 216 surveys completed by unique parents in 2021-2022 and used t-tests and linear regressions to assess the association between self-reported demographic factors and dependent measures of trust in providers, parent perceptions of primary care, and provider-patient interpersonal communication assessed using validated scales.

Results: Of the 216 total parent respondents, 45.4% (n=93) identified as Black, 61.2% (n=108) had children insured by Medicaid or CHIP, and 35.1% (n=65) were unemployed. Trust in primary care providers was lower for self-identified Black respondents as compared to their white counterparts (15.8 vs. 17.8, p=0.001). Trust in providers did not differ significantly by parent employment or child insurer. Parent perceptions of primary care was lower for Black respondents (64.4 vs. 74.3 for white respondents, p=0.002) and those with children insured by Medicaid or CHIP (67.3 vs. 76.9 for commercially insured respondents, p=0.0009). Parent perceptions of primary care did not differ significantly by parent employment. Within interpersonal processes of care, Black parents and parents of children insured by Medicaid or CHIP experienced greater lack of clarity and greater experiences of discrimination than white and commercially insured parents, respectively (p< 0.05, all), while unemployed parents reported less explanation of results than employed parents (p=0.004).

Conclusion(s): Experiences of primary care differed by parent race and ethnicity, parent employment, and child insurer. To promote equitable health outcomes, we must strive for equitable health systems and clinicians. Understanding these disparate experiences in our region can inform interventions to build health systems that are more effective and equitable in meeting individual patient contexts and needs.