Urology HEIRS: A Feasibility and Acceptability Study for Video-Based Research on Physician-Family Communication in Pediatric Urology Visits

Abstract

Purpose: Patient- and family-centered communication is essential to health care equity. However, less is known about how urologists implement evidence-based communication and dynamics involved in caring for diverse pediatric patients and caregivers. We sought to evaluate the feasibility and acceptability using video-based research to characterize physician-family communication in pediatric urology.

Materials and methods: We assembled a multidisciplinary team to conduct a multiphase learning health systems project and establish the Urology HEIRS (Health Experiences and Interactions in Real-Time Studies) corpus for research and interventions. This paper reports the first phase, evaluating feasibility and acceptability based on consent rate, patient diversity, and qualitative identification of verbal and paraverbal features of physician-family communication. We used applied conversation analysis methodology to identify salient practices across 8 pediatric urologists.

Results: We recruited 111 families at 2 clinic sites; of these 82 families (N = 85 patients, ages 0-20 years) participated in the study with a consent rate of 73.9%. The racial/ethnic composition of the sample was 45.9% non-Hispanic White, 30.6% any race of Hispanic origin, 16.5% non-Hispanic Black/African American, 4.7% any ethnicity of Asian/Asian American, and 2.3% some other race/ethnicity; 24.7% of families used interpreters. We identified 11 verbal and paraverbal communication practices that impacted physician-family dynamics, including unique challenges with technology-mediated interpreters.

Conclusions: Video-based research is feasible and acceptable with diverse families in pediatric urology settings. The Urology HEIRS corpus will enable future systematic studies of physician-family communication in pediatric urology and provides an empirical basis for specialty-specific training in patient- and family-centered communication.

Keywords: health communication; health equity; patient-physician relations; pediatric urology; qualitative research.

Figure 1.

Overview of the analytic process for conversation analysis.

Figure 2.

Urology HEIRS (Health Experiences and Interactions in Real-Time Studies) project phases. CA indicates conversation analysis.

Figure 3.

Diagnostic categories for recorded visits. Total counts do not equal N because some visits included multiple diagnoses.

Figure 4.

Frequency of observed activities. Total does not equal N because visits included multiple of each kind and some activities were not relevant to the visit type.