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Disparities in prognosis communication among parents of children with cancer: The impact of race and ethnicity
Author(s) -
Ilowite Maya F.,
Cronin Angel M.,
Kang Tammy I.,
Mack Jennifer W.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30960
Subject(s) - medicine , ethnic group , race (biology) , logistic regression , demography , cancer , family medicine , diversity (politics) , gerontology , botany , sociology , anthropology , biology
BACKGROUND Most parents of children with cancer say they want detailed information about their child's prognosis. However, prior work has been conducted in populations of limited diversity. The authors sought to evaluate the impact of parental race/ethnicity on prognosis communication experiences among parents of children with cancer. METHODS In total, 357 parents of children with cancer and the children's physicians were surveyed at Dana‐Farber Cancer Institute/Boston Children's Hospital and Children's Hospital of Philadelphia. Outcome measures were parental preferences for prognostic information, physician beliefs about parental preferences, prognosis communication processes, and communication outcomes. Associations were assessed by logistic regression with generalized estimating equations to correct for physician clustering. RESULTS Two hundred eighty‐one parents (79%) were white, 23 (6%) were black, 29 (8%) were Hispanic, and 24 (7%) were Asian/other. Eighty‐seven percent of parents wanted as much detail as possible about their child's prognosis, with no significant differences by race/ethnicity ( P = .75). However, physician beliefs about parental preferences for prognosis communication varied based on parent race/ethnicity, with physicians considering black and Hispanic parents less interested in details about prognosis than whites ( P = .003). Accurate understanding of a less favorable prognosis was greater among white (49%) versus nonwhite parents (range, 20%‐29%), although this difference was not statistically significant ( P = .14). CONCLUSIONS Most parents, regardless of racial and ethnic background, want detailed prognostic information about their child's cancer. However, physicians underestimate the information needs of black and Hispanic parents. To meet parents' information needs, physicians should ask about parents' information preferences before prognosis discussions. Cancer 2017;123:3995‐4003 . © 2017 American Cancer Society .