• Ana F El-Behadli, Patricia Gansert, and Deirdre E Logan.
• *Department of Clinical Psychology, UT Southwestern Medical Center †Center for Cancer and Blood Disorders, Children's Medical Center, Dallas, TX ‡Institute for Applied Research in Youth Development, Tufts University, Medford §Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Children's Hospital ∥Department of Psychiatry, Harvard Medical School, Boston, MA.
• Clin J Pain. 2017 Jun 1; 33 (6): 503-508.

ObjectiveParental responses to children's pain are related to how youth cope with chronic pain. However, little research has explored cultural differences in the 4 major pain response categories (ie, protect, minimize, distract, and monitor). This study compared parental responses to children's pain between minority parents (ie, black, Hispanic, multiracial) and parents of white children.Materials And MethodsParticipants included 234 patients, ages 8 to 17, with chronic pain (73.5% female; age M [SD]=13.91 [2.38]; 50% white, 15.39% black, 20.90% Hispanic, 13.68% multiracial). Patients' parents completed the Adult Responses to Children's Symptoms. Parental responses included: protect, monitor, minimize, and distrct. For between-group comparisons, white participants (N=117) were matched on age and sex with black (N=36), Hispanic (N=49), and multiracial (N=32) participants.ResultsPaired-samples t tests revealed that protectiveness was higher for parents of black children (t48=-3.84, P<0.001, black M [SD]=1.93 [0.69], white M [SD]=0.94 [0.77], Cohen d=1.09) and parents of Hispanic children (t71=-7.10, P<0.001, Hispanic M [SD]=1.65 [0.76], white M [SD]=0.94 [0.77], Cohen d=1.52) compared with parents of white children. In addition, parents of black children (t40=-2.90, P=0.006, black M [SD]=3.55 [0.49], white M [SD]=2.89 [0.93], Cohen d=0.80) and parents of Hispanic children (t71=-3.62, P<0.001, Hispanic M [SD]=3.35 [0.69], white M [SD]=2.89 [0.93], Cohen d=0.81) were significantly more monitoring their children than were parents of white children. Parents of Hispanic children were also significantly more minimizing than parents of white children (t71=-3.68, P<0.001, Hispanic M [SD]=0.88 [0.75], white M [SD]=0.51 [0.58], Cohen d=0.80). No other significant differences were found.DiscussionResults highlight the need to adapt pediatric chronic pain interventions to family culture and context. Further research is needed to understand pediatric chronic pain from a cross-cultural perspective.

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