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

Study Need and Importance: Patient and family centered communication is a hallmark of high quality, equitable patient care. Communication in pediatric urology presents unique challenges due to the diverse social, moral, and cultural expectations and goals of patients and families. Despite documented associations between communication and health outcomes, physician-family communication has been understudied in pediatric urology. Studying communication in real-world situations is necessary to gain insight into practices that enable or hinder effective, equitable care for diverse pediatric urology populations.

What We Found: For this study, we assembled a multidisciplinary team to establish the Urology HEIRS (Health Experiences and Interactions in Real-Time Studies) corpus for communication research, training, and interventions. This study phase evaluated the feasibility and acceptability of collecting video recordings of naturally occurring pediatric urology visits to study physician-family communication based on consent rate, patient diversity, and qualitative identification of salient communication practices using applied conversation analysis methodology. Eight pediatric urologists (100% consent) and 82 families (73.9% consent, N [85 patients, ages 0-20 years) participated in the study. 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% other race/ethnicity; 24.7% of families used interpreters. We identified 11 salient communication practices (Figure), including unique challenges with technology-mediated interpreters.

Limitations: This is the first study of its kind, and it is limited by the convenience sampling approach to evaluate the diversity of potential participants. It is also possible that participants altered their behavior due to the presence of the camera.

Interpretation for Patient Care: Video-based research is feasible and acceptable with diverse families in pediatric urology settings. The Urology HEIRS corpus will be used to develop an empirical basis for specialty-specific interventions to enhance and improve patient care.

Williamson et al. (2024) Urology HEIRS.pdf

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