RESEARCH BRIEF Differing Perspectives of Inner-City Parents and Pediatric Clinicians Impact Management of Iron-Deficiency Anemia Michelle B. Pierce, PhD, RD; Rebecca E. Crowell, MS; Ann M. Ferris, PhD, RD ABSTRACT Objective: To ascertain the beliefs and experiences of inner-city pediatric clinicians and parents regarding anemia in young children. Design: Focus groups and in-depth interviews. Setting: Pediatric clinics and community agencies in Hartford, Connecticut. Participants: Convenience sample of 41 pediatric clinicians (93% white, 73% female) and 85 parents (100% minority, 88% female, 47%  12 years education). Phenomenon of Interest: Identification, understanding, and management of anemia. Analysis: Researcher pairs coded complete transcriptions. Recurrent themes were identified, which were then contrasted and compared between clinicians and parents. Results: Both clinicians and parents were familiar with, but frustrated by the persistence of anemia. They noted time constraints and poor communication during office visits as contributing to the problem. Parents felt alarmed upon initial diagnosis; linked anemia with heredity, food patterns, and activity; reported culturally linked management strategies; but were uncertain of the seriousness. Health clinicians saw physiological processes as outside the parents’ understanding and emphasized prevention through feeding recommendations. Conclusions and Implications: In order to address childhood anemia effectively, differing socio- cultural perspectives of clinicians and parents need to be incorporated into a unified health care plan. Nutritionists are well suited to collaborate on the health care team to effectively address this issue. Key Words: anemia, iron deficiency, urban health, culture ( J Nutr Educ Behav. 2006;38:169-176) INTRODUCTION Iron-deficiency anemia in young children is a common nutritional problem. Even in developed countries such as the United States, where decreased prevalence of anemia is attributed to widespread iron fortification of foods and infant formulas, iron deficiency during the first 3 years of life persists. 1 Children from low-income U.S. families are disproportionately affected and are thus considered a high- risk group by the U.S. Centers for Disease Control (CDC). 2 In Hartford, Connecticut, where 41% of children live in poverty, 3 researchers estimate that 33% of children are anemic at least once between the ages of 18 and 36 months. 4 Researchers have reported similar frequencies in other cities. 5-9 Nutritional iron deficiency is considered the most common cause of anemia in young children. 2 Conse- quently, these data indicate a public health problem of moderate significance in these communities. 10 Furthermore, the data are alarming in light of the association between iron deficiency during infancy and subsequent impaired mental and motor development. 11-12 The high occurrence of anemia in Hartford is also perplexing. An estimated 90% of resident newborns are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which gives them access to iron-fortified infant formula and foods as a sup- plement to breast milk or when breastfeeding is discontin- ued. (S.S. Jackman, Breastfeeding Coordinator, State of Connecticut, Department of Public Health, unpublished data, 2004). In Connecticut, WIC regulations require he- moglobin concentration, an indicator of anemia, to be monitored once between 9 and 12 months of age and again between 15 and 18 months of age. Screenings are then Department of Nutritional Sciences, University of Connecticut, Storrs, CT Address for correspondence: Michelle B. Pierce, PhD, RD, Department of Nutri- tional Sciences, 3624 Horsebarn Road Extension, Unit 4017, University of Con- necticut, Storrs, CT 06269-4017; Tel: (860) 486-8904; Fax: (860) 486-3674; E-mail: michelle.pierce@uconn.edu ©2006 SOCIETY FOR NUTRITION EDUCATION doi: 10.1016/j.jneb.2006.01.003