Community‐based participatory research: an innovative approach for improving perioperative care of underserved children

Abstract

Pediatric disparities disproportionately affect Latino youth undergoing surgery and their families. As such, there is a critical need for culturally relevant frameworks that can advance perioperative intervention approaches in this population and reduce these disparities. In the following article, we first describe the methodological process of community-based participatory research (CBPR) and next report the results of the CBPR process that was conducted in this population. An interdisciplinary group of investigators, Latina mothers, and various other stakeholders met for a series of CBPR-based structured meetings. Qualitative data collection and analyses of the CBPR process were guided by principles of grounded theory that employs inductive techniques and constant comparison analyses until reaching saturation of data. Barriers identified in the process can be grouped within the following domains: child-related factors, family-related factors, health care provider factors, and hospital system factors. Family system factors category (coded references = 136) had the highest number of coded references; this category was found to be best described by the value of familismo or familism, including a duty to help family members when in need. The health care provider category (coded references = 42) was ranked second by frequency. Within this category, two major themes surfaced: health care provider cultural competence and overestimating health literacy. All barriers identified will be next incorporated in an innovative behavioral intervention that is currently being developed. We conclude that the model of CBPR can be used within the context of perioperative care of children and their families.

Engaging Parents in Analgesia Selection and Racial/Ethnic Differences in Analgesia Given to Pediatric Patients Undergoing Urologic Surgery

“…Future studies are needed to better assess specific mechanisms underlying parent decision-making. Triangulating methods to include qualitative and community-based approaches where community collaborators are involved in data interpretation may be particularly beneficial [21]. It is important to clarify that the literature does not have a clear indication that the use of caudal regional block vs. local anesthetic is considered a gold standard.…”

Special considerations in conducting clinical trials of chronic pain management interventions in children and adolescents and their families

“…This approach can be particularly valuable for addressing disparities in research participation. An example of community-based participatory research in pediatric perioperative care with Latino youth undergoing surgery and their families is described by Rosales et al 74 with the goal to reduce disparities in perioperative intervention approaches in minority populations.…”

Development of a child-centred community-based participatory research approach to injury prevention

“…Researchers can engage in them by, for example, positioning the community as a focal unit of identity, and facilitating an equitable, power-sharing partnership to address social inequities 6. Although CBPR approaches have been used to address children’s health and care more broadly,9 10 they are rarely used to understand children’s injury prevention needs 6 11. CBPR approaches to injury prevention are important to employ with children, as they can be used to mitigate injury experiences in diverse populations,1 3 and they can result in the development of programmes, initiatives and practices that support physical activity and outdoor learning 12 13…”