770 - Effects of Parental Acculturation on Cognitive, Emotional, and Behavioural Responses During Child Immunization

Publication Number: 770.4857

Lojain Hamwi, York University, Mississauga, ON, Canada; Daniel I. Flanders, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Eitan Weinberg, University of toronto, Toronto, ON, Canada; HARTLEY GARFIELD, 4169609877, TORONTO, ON, Canada; Deena Savlov, Universty of Toronto, Toronto, ON, Canada; Rebecca P. Pillai Riddell, Dr. Rebecca Pillai Riddell, Toronto, ON, Canada

Background: Acculturation (level of identification with one’s heritage and/or the dominant culture they live within) is recognized as a significant mechanism that influences pain perception and experiences (Miller & Abu-Alhaija, 2019). While existing research explores caregiver cultural/ethnic identification and behaviours, less work has examined how acculturation influences caregivers’ cognitive, emotional, and behavioural responses to infant pain. This study addresses this gap by investigating the role of parental acculturation on caregivers’ anxiety, pain judgment, and caregiving behaviours during their child’s immunization.

Objective: To explore the relationship between parental acculturation and their cognitive (toddler pain judgments), emotional (pre- and post-needle worry about needle pain), and behavioural (soothing and distress-promoting behaviours post-needle) responses to their child’s immunization pain.

Design/Methods: Caregivers (N = 221) of children ages 12-24 months undergoing routine immunizations completed a demographic questionnaire, rating how much their way of life reflected mainstream North American (NA) and heritage culture (0-10 scale). Cognitive responses were captured by caregivers’ post-needle pain judgments of their child’s pain, rated on a 0-10 scale. Emotional responses were assessed via self-reported state anxiety on a 0-10 scale, pre- and post-needle. Behavioural responses were coded using two validated systems: MAISD for soothing behaviours (e.g., physical comfort, rocking, verbal reassurance) and OUCHIE-RV for distress-promoting behaviours (e.g., affect incongruence, attention diversion, physical distance).

Results: Regression analyses revealed that parents who identified more with mainstream culture reported lower pain-related post-needle anxiety and perceived their child’s pain as less intense post-needle. Mainstream culture alignment was also linked to soothing behaviours before the needle, while heritage culture alignment was linked to soothing behaviours post-needle. Heritage culture identification had no significant effect on post-needle anxiety, pain perception, or distress-promoting behaviours.

Conclusion(s): The study provides evidence that parental acculturation, particularly alignment with mainstream NA culture, influences caregivers’ emotional responses (worry about child pain) and cognitive assessments (child pain judgment) during immunization. These findings highlight the importance of acculturative stress in shaping caregiving responses and suggest potential avenues for culturally-informed interventions to alleviate caregiver worry and distress during pediatric procedures.

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