Preferred Language, Patient‐Provider Interactions and Standardized Outcome Assessment in Patients with Pediatric Rheumatologic Conditions
Ahmad Bakhsh, Aditi Deokar, Gabrielle Alonzi, Madeline Hlobik, Mia T. Chandler, Edie Weller, Joyce C. ChangBackground
For families navigating juvenile idiopathic arthritis (JIA) or systemic lupus erythematosus (SLE), effective communication with healthcare teams is vital. We examined how language preference other than English (LPOE) associates with patient‐provider interactions and standardized outcome assessment.
Methods
In this retrospective cohort of patients with JIA or SLE at a tertiary care center (2016–2024), LPOE patients were matched 1:2 to English language preference (ELP) counterparts by age, diagnosis, polyarticular course and disease duration. We used multivariable negative binomial or logistic regression to compare rates of patient‐ and provider‐initiated communications, adjusted for disease severity indicators and the COVID‐19 pandemic period. Insurance and census tract‐level Child Opportunity Index (COI) were evaluated in separate models. We secondarily compared rates of physician global visual assessment scale (PhVAS) completion.
Results
We matched 60 JIA/SLE patients in LPOE families to 107 ELP counterparts. LPOE families initiated fewer communications in both unadjusted (incidence rate ratio [IRR] 0.45 [95% CI: 0.29–0.72]) and adjusted analyses (adjusted IRR [aIRR] 0.51 [95% CI: 0.31–0.84]). Moreover, LPOE families initiated 0.18‐fold fewer communications during the COVID‐19 pandemic (p<0.001 for interaction). There was no significant difference in provider‐initiated communication frequency by language preference. Physician VAS were less often completed for LPOE families (adjusted OR 0.58 [0.32–1.03]) , though this difference was not statistically significant.
Conclusion
Reduced communication frequency between LPOE families with care teams may drive language‐related disparities, particularly during periods of system stress. Enhanced outreach to families with barriers to health care engagement may facilitate more equitable care delivery.