Disparities in Provider Elicitation of Parents' Developmental Concerns for US Children

OBJECTIVE: To examine factors associated with provider elicitation of parents' developmental concerns among US children. METHODS: The 2007 National Survey of Children's Health was used to examine factors associated with parents' reports of provider elicitation of developmental concerns in the previous 12 months. Independent variables included child characteristics, sociodemographic factors, insurance status, and having a medical home. RESULTS: One-half of US parents reported provider elicitation of developmental concerns. African-American (41%) and Latino (49% in households with English as the primary language and 33% with a non-English primary language) parents were significantly less likely than white parents (55%) to report elicitation of developmental concerns. With multivariate adjustment, African-American (odds ratio [OR]: 0.67 [95% confidence interval [CI]: 0.55-0.81]) and Latino (OR: 0.61 [95% CI: 0.44-0.84]) parents, compared with white parents, had significantly lower adjusted odds of provider elicitation of developmental concerns. Lack of insurance (OR: 0.61 [95% CI: 0.44-0.85]) and having a medical home (OR: 1.42 [95% CI: 1.21-1.67]) were associated with elicitation of developmental concerns. Parents of African-American and Latino children who received family-centered care had almost twice the odds of provider elicitation. For Latino parents in households with a non-English primary language, other medical home components, including having a personal provider (OR: 1.51 [95% CI: 1.08-2.11]) and a usual source of care (OR: 1.76 [95% CI: 1.13-2.74]), were significantly associated with elicitation of developmental concerns. CONCLUSIONS: Racial/ethnic and linguistic disparities exist in provider elicitation of developmental concerns. Addressing lack of insurance, medical homes, and specific medical-home components might reduce disparities. Pediatrics 2011; 128: 901-909