Objective: To examine childhood fever beliefs and practices in a multiethnic, multiracial, and socioeconomically diverse sample.
Design: Cross-sectional survey.
Participants: Parents of children attending a hospital clinic, neighborhood health center, and a private practice.
Results: Two hundred seventy-four parents were interviewed; 45% were Latino; 15%, African-American; 25%, white; and 14%, other (excluded from further analysis, leaving a final sample size of 235). Latinos (11%) and African-Americans (7%) were more likely than whites (0%) to have no thermometers (P < 0.006). Only 42% of parents knew the correct temperature for fever. Greater proportions of Latinos (55%) and African-Americans (44%) take their child to the emergency department for fever than whites (21%; P < 0.001 and P = 0.02, respectively). Multivariate analyses revealed that parents who had not graduated from high school had 5 times the odds of not using a thermometer to check for fever and triple the odds of not asking a health care provider for fever advice, and parents of uninsured children were 5 times less likely to bring their febrile child to the emergency department. Low-income parents significantly more often used the emergency department and remedies other than antipyretics for their febrile children. Latino parents were more likely to believe that certain Latino folk illnesses cause fever, and African-American parents had triple the odds of not knowing the correct temperature for fever.
Conclusions: Parents' beliefs and practices regarding childhood fever vary by race, ethnicity, sociodemographics, and the child's insurance coverage. Educating parents about fever, improving access to health insurance and primary care, and ensuring that families have thermometers may enhance appropriate use of health services and improve outcomes for febrile children.
*Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA; †Kaiser Permanente Medical Group, Hayward Medical Center, Hayward, CA and ‡Center for the Advancement of Urban Children, Department of Pediatrics, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI.
Presented in part at the annual meeting of the Pediatric Academic Societies on May 3, 1999, in San Francisco, CA. Supported by grants from the American Academy of Pediatrics Resident Research Award (Dr. Taveras) and the Endowment for the Children of the City of Boston. Dr. Flores is supported by an Independent Scientist Award from the Agency for Healthcare Research and Quality and grants from the Generalist Physician Faculty Scholars Program and the Minority Medical Faculty Development Program of the Robert Wood Johnson Foundation.
Address correspondence and reprint requests to Glenn Flores, MD, Center for the Advancement of Urban Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226. E-mail: email@example.com.