Parental limited comfort with English could impact child’s hospitalization


Hospitalization is a potentially fraught period for a child’s health. An investigation examines whether a parent’s limited comfort with English could exacerbate outcomes.

In recent years there has been a concerted push to increase health literacy among patients and their families. However, these efforts may not have addressed families who have limited comfort with English and the impact that has on health outcomes. An investigation in JAMA Pediatrics looks at whether parental limited comfort with English is linked to higher odds of adverse events in children who are hospitalized.1

Investigators ran a multicenter prospective cohort study from December 2014 to January 2017. It was run concurrent with the data collection for the Patient and Family Centered I-PASS Study, which was a clinician-to-family communication and patient safety intervention study. The population included Arabic-, Chinese-, English-, and Spanish-speaking parents who had both general pediatric and subspecialty children aged 17 years and younger who were in the pediatric units of 7 hospitals in North America.

There were 1666 parents included in the study, with 80.5% being female and an average of 35.4 years. Within this cohort, 147 parents stated that they had limited comfort with English and 105 of those parents said that they preferred Spanish. When compared with children who had parents that expressed comfort with English, children with parents who said they had limited comfort with English were found to have higher odds of having 1 or more adverse events (26 of 147 [17.7%] vs 146 of 1519 [9.6%]; adjusted odds ratio, 2.1; 95% CI, 1.2-3.7). This was following adjusting for parent race and education, complex chronic conditions, length of stay, site, and the intervention period. Additionally, the children of parents with expressed limited comfort with English were also more likely to experience 1 or more preventable adverse events (adjusted odds ratio, 2.3; 95% CI, 1.2-4.2).

The researchers concluded that children who are hospitalized and have parents who said they had limited comfort with English were twice as likely to experience an adverse event. They believe that strategies meant to improve communication could improve the outcomes for these children.


1. Khan A, Yin H, Brach C, et al. Association between parent comfort with english and adverse events among hospitalized children. JAMA Pediatr. October 19, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.3215

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