A Systematic Review of Race/Ethnicity and Parental Treatment Decision-Making

Clin Pediatr (Phila). 2018 Oct;57(12):1453-1464. doi: 10.1177/0009922818788307. Epub 2018 Jul 17.

Abstract

Patient race/ethnicity affects health care utilization, provider trust, and treatment choice. It is uncertain how these influences affect pediatric care. We performed a systematic review (PubMed, Scopus, Web of Science, PsycINFO, Cochrane, and Embase) for articles examining race/ethnicity and parental treatment decision-making, adhering to PRISMA methodology. A total of 9200 studies were identified, and 17 met inclusion criteria. Studies focused on treatment decisions concerning end-of-life care, human papillomavirus vaccination, urological surgery, medication regimens, and dental care. Findings were not uniform between studies; however, pooled results showed (1) racial/ethnic minorities tended to prefer more aggressive end-of-life care; (2) familial tradition of neonatal circumcision influenced the decision to circumcise; and (3) non-Hispanic Whites were less likely to pursue human papillomavirus vaccination but more likely to complete the vaccine series if initiated. The paucity of studies precluded overarching findings regarding the influence of race/ethnicity on parental treatment decisions. Further investigation may improve family-centered communication, parent engagement, and shared decision-making.

Keywords: caregiver; decision-making; parent; pediatrics; race/ethnicity; systematic review; treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Attitude to Health / ethnology*
  • Circumcision, Male / psychology
  • Circumcision, Male / statistics & numerical data
  • Decision Making*
  • Dental Care / psychology
  • Dental Care / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data*
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data
  • Papillomavirus Vaccines
  • Parents / psychology*
  • Racial Groups / psychology
  • Racial Groups / statistics & numerical data*
  • Terminal Care / psychology
  • Terminal Care / statistics & numerical data

Substances

  • Papillomavirus Vaccines