Caring for Children in Immigrant Families: Are United States Pediatricians Prepared?

Abstract

A growing number of children in the United States are from immigrant families. We conducted a national survey to examine pediatricians' self-rated preparedness to care for children in immigrant families. A 2017 survey of American Academy of Pediatrics members assessed respondent characteristics, formal training in and experience with global, public, or immigrant health, and preparedness to care for children in immigrant families. Descriptive statistics and a multivariable logistic regression model examined associations between characteristics, formal training, experience, and preparedness. The survey response rate was 47% (n = 758/1628). One third of respondents (33.6%) reported being unprepared to care for children in immigrant families. In bivariate analyses, respondents who had graduated from medical school outside of the United States, had previous education on immigrant health care, or had recent international global health experience were most likely to report feeling prepared to care for children in immigrant families. Multivariable regression model results indicated that prior education on immigrant health (adjusted odds ratio [AOR] 4.07; 95% confidence interval [CI] 2.68, 6.32), graduation from medical school outside the United States (AOR 2.35; 95% CI 1.22, 4.67), and proficiency in a language other than English (AOR 1.78; 95% CI 1.14, 2.80) were independently associated with preparedness. One in 3 US pediatricians report being unprepared to care for children in immigrant families. Wider implementation of graduate and continuing medical education on immigrant child health is needed to ensure that practicing pediatricians have the appropriate skills and knowledge to care for this patient population.