Racial Disparities in the Pediatric Intensive Care Unit and How They Influence Parental Trust

Objective: Parental trust level in physicians is an extremely important aspect of care in the pediatric intensive care unit (PICU). Many studies have shown that the race and ethnicity of a patient or parent influences trust in the physician. This study looked at whether race or ethnicity predict the total trust level in physicians and if any other demographic variables influence the association. Additionally, it tested how different aspects of communication between the parent and physician influence the parental trust total score and how race and ethnicity influence these associations. Methods: Parents with a child in the PICU for a minimum of 48 hours were given an oral survey of 4 different questionnaires. The Pediatric Trust in Physicians Survey (Pedi-TIPS) was the main outcome variable. A second interview was attempted one week after the initial interview to assess the consistency of the Honesty, Inclusive, Compassion, Comprehensive, and Coordinated (HICCC) questionnaire and the Pedi-TIPS total score. Results: One hundred forty-nine parents participated in the study. There was a significant difference between the races on mean Pedi-TIPS total score in the initial, unadjusted analysis (p=0.0043). In particular, the mean (SD) Pedi-TIPS total score for the study sample was 43.5 (5.7). By race, Caucasians had the highest total score mean at 45.7 while African Americans had the lowest total mean score at 41.8. No significant association was observed between Hispanic and Non-Hispanics (p=0.4796). The parent’s relationship status confounded the association between race and trust level (p=0.0649). All 6 HICCC variables were associated with the total score. The question “Do you [the parent] want more updates?” was the only question no longer significantly associated with the trust level when adjusting for race only. Conclusions: Race appears to influence the trust level of a parent. In addition, how the parent perceives their communication with the physician also has an influence on the parent’s trust in the physician caring for their child. The relationship status of the parent makes the association between race and trust level non-significant, possibly indicating this relationship does not actually exist.M.P.H., Public Health -- Drexel University, 201