# Shared Decision-Making in Children’s Healthcare by Parents’ Immigrant Status: Findings from the 2021–2022 U.S. National Survey of Children’s Health

## TL;DR

Immigrant parents in the U.S. are more likely to report lower shared decision-making in their child's healthcare compared to U.S.-born parents.

## Contribution

This study identifies disparities in shared decision-making by immigrant status and highlights factors that may contribute to these disparities.

## Key findings

- Immigrant parents reported lower levels of shared decision-making in their child's healthcare.
- Needing extra help arranging care was associated with significantly higher odds of low shared decision-making among immigrant parents.

## Abstract

The increasing immigrant population in the U.S. faces unique challenges in navigating the healthcare system, including language and cultural barriers, and knowledge of services. Immigrant parents may face additional challenges as they attempt to navigate the healthcare system on behalf of their children. This study investigated associations between parents’ immigrant status and their perceptions of shared decision-making (SDM) in their child’s healthcare. Participants included 27,082 parent respondents from U.S. households in the 2021-22 National Survey of Children’s Health. Measures included parents’ immigrant status and reports of shared decision-making in their child’s healthcare. Potential moderators of the association between immigrant status and SDM included time spent providing or arranging children’s healthcare, household economic strain, parenting support, needing extra help to arrange care, and household language. Logistic regression analyses showed that compared to U.S.-born parents, immigrant parents were more likely to report lower levels of SDM. Immigrant parents who reported needing extra help coordinating or arranging healthcare services for their child had significantly higher odds of low SDM compared to their counterparts. To improve child health outcomes, immigrant families may benefit from increased SDM and support in coordinating their children’s healthcare services.

The online version contains supplementary material available at 10.1007/s10903-025-01771-1.