Comparison of Telemedicine Usage at Two Distinct Medicaid-Focused Pediatric Clinics.

To compare telemedicine versus office visit use at two Medicaid-focused pediatric primary care clinics. Retrospective cohort study from March 15, 2020 - March 15, 2021 at two Medicaid-focused pediatric primary care clinics. Site A and Site B care for different populations (Site B care for mostly immigrant families with preferred language Spanish).

Surgeon Information-Sharing, Parent Verbal Engagement, and Parent Knowledge of Pediatric Adenotonsillectomy.

Objective: We characterize clinician information-sharing and parent verbal engagement during pediatric adenotonsillectomy consultations and evaluate whether these behaviors relate to disease-specific knowledge for parents of children with obstructive sleep-disordered breathing (OSDB).

Study Design: Mixed-methods sequential explanatory analysis.

Setting: Outpatient otolaryngology clinics.

Provider Perspectives Regarding Ambulatory Telemedicine at a Large Academic Health System During the COVID-19 Pandemic.

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Parental Expression of Emotions and Surgeon Responses During Consultations for Obstructive Sleep-Disordered Breathing in Children.

Importance: Little is known about emotional communication between parents and surgeons. Understanding the patterns and correlates of emotional communication may foster collaboration during surgical consultations.

Objective: To describe the emotional expressions by parents when bringing their child for evaluation of obstructive sleep-disordered breathing (SDB) as well as surgeon responses to these emotional expressions and to evaluate the association between parental demographic characteristics and surgeon response types.

Parent Experience of Communication about Children's Surgery: A Qualitative Analysis.

Unlabelled: Parent experience is a core component of the quality of pediatric care and an increasingly common focus of quality improvement initiatives. However, the parent experience of communication in the pediatric surgical setting remains unexplored.

Methods: We conducted semi-structured interviews with 20 parents of children undergoing surgery.

Understanding Bias in Surgery: Perceived Cultural Similarity Between Surgeons and Patient Families.

Objective: We describe surgeon and parent perceptions of similarity toward each other and evaluate differences in the perceptions of similarity by race.

Study Design: Observational cohort analysis.

Setting: Three outpatient sites.

Assessment of Parental Choice Predisposition for Tonsillectomy in Children.

Importance: The decision to proceed with tonsillectomy to treat pediatric obstructive sleep-disordered breathing (OSDB) often falls on individual families. Despite emphasis on shared decision-making between parents and surgeons about tonsillectomy for OSDB, the extent to which parents have already decided about surgery prior to the child's consultation is not known.

Objective: To identify predictors of parent choice predisposition for surgical treatment of OSDB with tonsillectomy and describe its association with parent-clinician communication.

Treatment recommendations to parents during pediatric tonsillectomy consultations: A mixed methods analysis of surgeon language.

Objective: A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. We characterize how otolaryngologists provide treatment recommendations and suggest a classification framework.

Methods: We qualitatively analyzed surgeon recommendations from 55 encounters between otolaryngologists and parents of children evaluated for tonsillectomy, and classified recommendation types by phrasing.

The Effect of Language Barriers at Discharge on Pediatric Adenotonsillectomy Outcomes and Healthcare Contact.

Objective: Effective delivery of discharge instructions and access to postoperative care play a critical role in outcomes after pediatric surgery. Previous studies in the pediatric emergency department suggest that caregivers with language barriers have less comprehension of discharge instructions despite use of interpretation services. However, the impact of language barriers during discharge on surgical outcomes in a pediatric surgical setting has not been studied.

Speaking in Tongues: What Parents Really Think About Tongue-Tie Surgery for Their Infants.

We evaluate maternal perspectives of frenotomy for ankyloglossia in newborns. We searched highly frequented forums like babycenter.com for comments related to frenotomy posted from 2012 to 2017.

Parental role in decision-making for pediatric surgery: Perceptions of involvement in consultations for tonsillectomy.

Objective: Parental role in decision-making has implications for quality of care. We describe roles of parent participation in decision-making for tonsillectomy.

Methods: Parents reported preferred role in decision-making before consultations for tonsillectomy and the role they experienced after their consult.

Identification of Potential Barriers to Timely Access to Pediatric Hearing Aids.

Importance: Despite various barriers identified to early pediatric access to cochlear implantation, barriers to timely access to pediatric hearing aids are not well characterized.

Objective: To identify socioeconomic, demographic, and clinical factors that may be associated with pediatric access to hearing aids.

Design, Setting, And Participants: This retrospective cohort study included 90 patients aged 1 to 15 years who were referred for auditory brainstem response (ABR) testing and evaluation for hearing aids at a single tertiary care academic medical center from March 2004 to July 2018.

Evaluation of Parental Perspectives and Concerns About Pediatric Tonsillectomy in Social Media.

Importance: Tonsillectomy is common in children, but little is known about parental preferences and values concerning this surgical procedure. Twitter offers an opportunity to evaluate parental understanding and experience of tonsillectomy care.

Objective: To identify parental perspectives about tonsillectomy in children that may not be apparent in a routine clinical encounter.

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

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.

Follow-up and Time to Treatment in an Urban Cohort of Children with Sleep-Disordered Breathing.

Objective To evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Study Design Retrospective longitudinal cohort analysis. Setting Tertiary health system.

An expanded framework to define and measure shared decision-making in dialogue: A 'top-down' and 'bottom-up' approach.

Objectives: We aimed to develop a comprehensive, descriptive framework to measure shared decision making (SDM) in clinical encounters.

Methods: We combined a top-down (theoretical) approach with a bottom-up approach based on audio-recorded dialogue to identify all communication processes related to decision making. We coded 55 pediatric otolaryngology visits using the framework and report interrater reliability.

Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement.

Objective: Tympanostomy tube (TT) placement is common in children; however, family-centeredness and utility of online information used for decision making and understanding is unknown. We evaluate the quality of leading Internet resources describing TT placement.

Study Design: Cross-sectional descriptive design.

Physician Perspectives on Decision Making for Treatment of Pediatric Sleep-Disordered Breathing.

Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents.

Stakeholder-Engaged Measure Development for Pediatric Obstructive Sleep-Disordered Breathing: The Obstructive Sleep-Disordered Breathing and Adenotonsillectomy Knowledge Scale for Parents.

Importance: Parental decision making about adenotonsillectomy (AT) for obstructive sleep-disordered breathing (oSDB) is associated with decisional conflict that may be alleviated with improved knowledge about symptoms and treatments.

Objective: To develop a measure of parental knowledge about oSDB and AT.

Design, Setting, And Participants: A sequential design was used for scale development.

Parent Experience of Care and Decision Making for Children Who Snore.

Importance: Sleep-disordered breathing (SDB) is prevalent and has an impact on the physical and behavioral health of children. Adenotonsillectomy (AT), the primary treatment, is subject to unexplained variation in utilization, which may be reduced by improving physician-patient communication and decision quality for this elective procedure.

Objective: To identify factors are associated with parental experience and decision making in pediatric SDB and AT surgery.