Relationship between Teach-back and patient-centered communication in primary care pediatric encounters

Adam Badaczewski, Laurie J. Bauman, Arthur E. Blank, Benard Dreyer, Mary Ann Abrams, Ruth E.K. Stein, Debra L. Roter, Jobayer Hossain, Hal Byck, Iman Sharif

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Objective We proposed and tested a theoretical framework for how use of Teach-back could influence communication during the pediatric clinical encounter. Methods Audio-taped pediatric primary care encounters with 44 children with asthma were coded using the Roter Interaction Analysis System to measure patient-centered communication and affective engagement of the parent. A newly created Teach-back Loop Score measured the extent to which Teach-back occurred during the clinical encounter; parental health literacy was measured by Newest Vital Sign. Logistic regression was used to test the relationship between Teach-back and features of communication. Focus groups held separately with clinicians and parents elicited perceptions of Teach-back usefulness. Results Teach-back was used in 39% of encounters. Visits with Teach-back had more patient centered communication (p = 0.01). Adjusting for parent health literacy, parent age, and child age, Teach-back increased the odds of both patient centered communication [proportional AOR (95% CI) = 4.97 (4.47–5.53)]and negative affect [AOR (95% CI) = 5.39 (1.68–17.31)]. Focus group themes common to clinicians and parents included: Teach-back is effective, could cause discomfort, should be used with children, and nurses should use it. Conclusions Teach-back was associated with more patient-centered communication and increased affective engagement of parents. Practice implications Standardizing Teach-back use may strengthen patient-centered communication.

Original languageEnglish (US)
Pages (from-to)1345-1352
Number of pages8
JournalPatient Education and Counseling
Issue number7
StatePublished - Jul 2017


  • Communication
  • Global affect
  • Patient-centered
  • Teach-back

ASJC Scopus subject areas

  • General Medicine


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