Parent‐Identified Barriers to Pediatric Health Care: A Process‐Oriented Model

Sobo, Elisa J.; Seid, Michael; Gelhard, Leticia Reyes

doi:10.1111/j.1475-6773.2005.00455.x

Cited by 81 publications

(55 citation statements)

References 37 publications

(41 reference statements)

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“…First, we used a small, non-representative sample of mothers who use pediatric primary care in a particular community. However, many of our findings echo results from previous studies suggesting that the pediatric primary care experiences of the LEP mothers in this study may reflect the experiences of other LEP Latina mothers in the United States [13, 38–41, 46, 47, 55]. Second, many of our study participants had participated in a prior research study in the community.…”

Section: Discussionsupporting

confidence: 81%

“…The importance of same-day sick care among Latina mothers is not unique to this study and may be related to immigrant Latinos’ being accustomed to a walk-in system of care, common in Mexico and many Central American countries, or culturally-based fears about fever and other signs/symptoms of illness [38, 39, 43–45]. Prioritization of same-day sick care among Latina mothers, may contribute to reported disparities in the timeliness of care for Latino children [13, 46, 47]. Designing an optimal clinic appointment system in a clinic serving Latino families may require integrating the priority for same-day sick care with other aspects of care, while maximizing efficiency.…”

Section: Discussionmentioning

confidence: 99%

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The Voices of Limited English Proficiency Latina Mothers on Pediatric Primary Care: Lessons for the Medical Home

DeCamp

Kieffer

Zickafoose

et al. 2012

Matern Child Health J

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The objective of this study is to inform medical home implementation in practices serving limited English proficiency Latino families by exploring limited English proficiency Latina mothers’ experiences with, and expectations for, pediatric primary care. In partnership with a federally-qualified community health center in an urban Latino neighborhood, we conducted semi-structured interviews with 38 low-income Latina mothers. Eligible participants identified a pediatric primary care provider for their child and had at least one child 3 years old or younger, to increase the probability of frequent recent interactions with health care providers. Interview transcripts were coded and analyzed through an iterative and collaborative process to identify participants’ satisfaction with and expectations for pediatric primary care. About half of the mothers interviewed were satisfied with their primary care experiences. Mothers suggested many ways to improve the quality of pediatric primary care for their children to better meet the needs of their families. These included: encouraging providers to invest more in their relationship with families, providing reliable same-day sick care, expanding hours, improving access to language services, and improving care coordination services. Limited English proficiency Latina mothers expect high-quality pediatric primary care consistent with the medical home model. Current efforts to improve primary care quality through application of the medical home model are thus relevant to this population, but should focus on the parent-provider relationship and timely access to care. Promoting this model among practices that serve limited English proficiency Latino families could improve engagement and satisfaction with primary care.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

The Voices of Limited English Proficiency Latina Mothers on Pediatric Primary Care: Lessons for the Medical Home

DeCamp

Kieffer

Zickafoose

et al. 2012

Matern Child Health J

View full text Add to dashboard Cite

show abstract

“…39 Low income uninsured children are at higher risk for experiencing communication problems-fully one in three had parents who said that health care providers never or only sometimes listened and explained things carefully. From this study, we cannot identify the mechanisms through which this effect is operating 40 -it may be the case that there is more heterogeneity in the quality of providers serving uninsured children than among those serving other children, or that providers spend less time with them than with other patients, reducing the quality of communication. Understanding the root causes of the high prevalence of communication problems facing uninsured children is important since poor communication may compound other access problems that they experience.…”

Section: Discussionmentioning

confidence: 94%

Low Income Parents' Reports of Communication Problems with Health Care Providers: Effects of Language and Insurance

Clemans-Cope

Kenney

2007

Public Health Rep

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SYNOPSISObjectives. This study examines how parental reports of communication problems with health providers vary over a wider range of characteristics of low income children than considered in previous studies.Methods. Data were drawn from the 1999 and 2002 National Survey of America's Families. Communication problems, insurance type, socioeconomic characteristics, health factors, and provider type were examined. Data were analyzed using bivariate and multivariate techniques.Results. Bivariate analysis identified that the parents of 24.4% of low income children and 36.4% of publicly covered low income children with a Spanish interview reported poor communication with health providers. Coefficients from regression analysis suggest that, controlling for covariates, foreign-born parents with a Spanish interview were 11.8 percentage points (p,0.01) more likely to report communication problems than U.S.-born parents with an English interview. Among low income publicly covered children with a Spanish interview, regression analysis suggests that parents of children who used clinics or hospital outpatient departments as their usual source of care were 9.5 percentage points (p,0.05) more likely to report communication problems compared with those whose usual source of care was a doctor's or HMO office.Conclusions. Implementing policies to improve communication barriers for low income children, particularly those with foreign-born parents whose native language is not English, may be necessary to reduce health disparities relative to higher income children across a variety of health domains including utilization, satisfaction, and outcomes. Focusing attention on the availability of professional translation services in clinics or hospital outpatient departments may be a cost-effective strategy for reducing communication problems for publicly insured children.

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“…In order to secure optimal treatment for their children, parents must adjust to the logistical and emotional demands of caring for a seriously sick child while also learning how to navigate the complex health care system (Sobo, Seid, & Gelhard, 2006). As caregivers of seriously ill children, parents must navigate their child’s health care which includes communicating with clinicians, coordinating their child’s care across numerous physicians, managing treatment outside of the clinical setting, and making decisions on behalf of their children (Markides, 2011; Sobo et al, 2006). …”

Section: Navigating Pediatric Cancer Carementioning

confidence: 99%

Social support, flexible resources, and health care navigation

Gage‐Bouchard

2017

Social Science & Medicine

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Recent research has focused attention on the role of patients’ and clinicians’ cultural skills and values in generating inequalities in health care experiences. Yet, examination of how social structural factors shape people’s abilities to build, refine, and leverage strategies for navigating the health care system have received less attention. In this paper I place focus on one such social structural factor, social support, and examine how social support operates as a flexible resource that helps people navigate the health care system. Using the case of families navigating pediatric cancer care this study combines in-depth interviews with parents of pediatric cancer patients (N = 80), direct observation of clinical interactions between families and physicians (N = 73), and in-depth interviews with pediatric oncologists (N = 8). Findings show that physicians assess parental visibility in the hospital, medical vigilance, and adherence to their child’s treatment and use these judgments to shape clinical decision-making. Parents who had help from their personal networks had more agility in balancing competing demands, and this allowed parents to more effectively meet institutional expectations for appropriate parental involvement in the child’s health care. In this way, social support served as a flexible resource for some families that allowed parents to more quickly adapt to the demands of caring for a child with cancer, foster productive interpersonal relationships with health care providers, and play a more active role in their child’s health care.

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Parent‐Identified Barriers to Pediatric Health Care: A Process‐Oriented Model

Cited by 81 publications

References 37 publications

The Voices of Limited English Proficiency Latina Mothers on Pediatric Primary Care: Lessons for the Medical Home

The Voices of Limited English Proficiency Latina Mothers on Pediatric Primary Care: Lessons for the Medical Home

Low Income Parents' Reports of Communication Problems with Health Care Providers: Effects of Language and Insurance

Social support, flexible resources, and health care navigation

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