Preferred Language, Patient-Provider Interactions and Standardized Outcome Assessment in Patients With Pediatric Rheumatologic Conditions.

OBJECTIVE

For families navigating juvenile idiopathic arthritis (JIA) or systemic lupus erythematosus (SLE), effective communication with health care 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), patients with LPOE were matched one-to-two 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 and adjusted for disease severity indicators and the COVID-19 pandemic period. Insurance and census tract-level Child Opportunity Index were evaluated in separate models. We secondarily compared rates of physician visual analog scale (PhVAS) completion.

RESULTS

We matched 60 patients with JIA/SLE in families with LPOE to 107 counterparts with ELP. Families with LPOE initiated fewer communications in both unadjusted (incidence rate ratio [IRR] 0.45 [95% confidence interval [CI] 0.29-0.72]) and adjusted analyses (adjusted IRR [aIRR] 0.51 [95% CI 0.31-0.84]). Moreover, families with LPOE 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. PhVAS were less often completed for families with LPOE (adjusted OR 0.58 [0.32-1.03]), but this difference was not statistically significant.

CONCLUSION

Reduced communication frequency between families with LPOE 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.