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The objectives of this study were to test whether there are ethnic differences in parents’ perceptions of the participatory styles of their children's physicians, and to determine how Hispanic ethnicity influences the factors that are correlated with the perceptions of participatory styles.We conducted a population-based cross-sectional telephone survey in 111 counties of West Texas. Parents of children and adolescents 3 to 18 years of age (n = 3876) were included in analyses.The participatory decision-making (PDM) style of physicians was measured by a 3-item instrument used in the Medical Outcomes Study. Multivariate analyses were performed to identify ethnic differences and whether the effect of independent variables on participatory style varied by ethnicity.The t test showed that the mean participatory decision-making score for Hispanics was significantly lower than that for non-Hispanic whites (P <0.01). However, the variance of the PDM score among Hispanics was greater than that among non-Hispanic whites using an F test (P = 0.03). After controlling for other independent variables, the effect of ethnicity was still significant. The association between PDM scores and a child's insurance and the parent's age varied by ethnicity. Parents’ age, education, self-employment status, and income were associated with non-Hispanic white parents’ perceptions of physicians’ PDM, whereas children's insurance, parents’ education and income were associated with Hispanic parents’ perceptions of physicians’ PDM (P <0.05).Because patient participation is closely related to health outcomes and patient satisfaction, improving Hispanic patients’ participation can be 1 avenue for diminishing ethnic disparities in health. Further research is needed to establish whether ethnic differences in children's physicians’ participation style exist from physicians’ perspective and whether the differences are associated with physicians’ characteristics.