An evaluation of physicians' engagement of children with asthma in treatment-related discussions

Delesha M. Carpenter, Angela Stover, Catherine Slota, Guadalupe X. Ayala, Karen Yeatts, Gail Tudor, Stephanie Davis, Dennis Williams, Betsy Sleath

Research output: Contribution to journalArticle

14 Scopus citations


Our objectives were to examine whether providers engage children with asthma in treatment-related discussions at the level children prefer (engagement concordance) and to determine whether engagement concordance is related to child, caregiver, and provider characteristics. Children with asthma (n = 296) aged 8-16 years were recruited at five pediatric practices in North Carolina. Using audiotaped medical visit transcripts, we documented the number of treatment-related questions the providers asked the children. Children reported their preferred level of provider engagement. A logistic generalized estimating equation was used to determine which variables predicted engagement concordance. Most children (96.6%) wanted to be involved in treatment-related discussions. One-third of the providers did not ask children any treatment-related questions. Only 36.1% of provider-child dyads were concordant. Most discordant dyads were under-engaged (83.1%). Better engagement concordance was observed among older children (odds ratio (OR) = 1.19, 95% confidence interval (CI) (1.07, 1.33)), male children (OR = 1.67, 95% CI (1.03, 2.70)), and among providers with fewer years in practice (OR =.97, 95% CI (.94,.99)). Providers engaged in treatment-related discussions with younger children and females less frequently than these children preferred. Providers should ask children how much they want to be involved in treatment-related discussions and then attempt to engage children at the level they prefer.

Original languageEnglish (US)
Pages (from-to)261-274
Number of pages14
JournalJournal of Child Health Care
Issue number3
StatePublished - Sep 2014



  • Adolescent
  • chronic illness
  • communication
  • family-centered care
  • medication

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pediatrics

Cite this

Carpenter, D. M., Stover, A., Slota, C., Ayala, G. X., Yeatts, K., Tudor, G., Davis, S., Williams, D., & Sleath, B. (2014). An evaluation of physicians' engagement of children with asthma in treatment-related discussions. Journal of Child Health Care, 18(3), 261-274.