African-American parents' perceptions of partnership with their child's primary care provider.

OBJECTIVE: To identify family, provider, and healthcare setting characteristics associated with African-American parents' perceptions of partnership with their child's primary care provider. STUDY DESIGN: Data were collected via a telephone survey of 425 African-American parents of 0- to 5-year-old children who had presented for a health visit 1 to 2 weeks earlier at participating pediatric primary care practices in Washington, DC. Parents' perceptions of the level of partnership building by their child's provider were assessed using the Street Provider Communication Style instrument. RESULTS: Multivariate logistic regression models indicated that, after adjusting for other family and provider/setting characteristics, parents seen in community health centers were more likely to report high partnership building compared with parents seen at private or hospital-based practices. Parents with at least a college education and those who described their child's provider's race as "other" were most likely to report moderate partnership building. CONCLUSIONS: Future studies should examine elements of care delivery at community health centers that may lead to better partnerships between parents and providers in private and hospital-based practice settings.

Beliefs about the appropriate age for initiating toilet training: are there racial and socioeconomic differences?

OBJECTIVE: To examine racial and socioeconomic differences in parental beliefs about the appropriate age at which to initiate toilet training. STUDY DESIGN: A cross-sectional survey of 779 parents visiting child health providers in 3 clinical sites in Washington, DC and the surrounding metropolitan area completed a self-report survey. The main outcome variable was parental beliefs about the appropriate age at which to initiate toilet training. Using multiple linear regression, differences in beliefs were assessed in relation to race, family income, parental education, parental age, and age of the oldest and youngest children. RESULTS: Among respondents, parents felt that the average age at which toilet training should be initiated was 20.6 months (+/-7.6 months), with a range of 6 to 48 months. Caucasian parents believed that toilet training should be initiated at a significantly later age (25.4 months) compared with both African-American parents (18.2 months) and parents of other races (19.4 months). In the multiple regression model, factors predicting belief in when to initiate toilet training were Caucasian race and higher income. CONCLUSIONS: Race and income were independent predictors of belief in age at which to initiate toilet training. More research is needed to determine what factors contribute to toilet training practices in diverse populations.