The RICHER Social Pediatrics Model: Fostering Access and Reducing Inequities in Children's Health

Lynam, M. Judith; Scott, Lorine; Loock, Christine; Wong, Sabrina T.

doi:10.12927/hcq.2011.22576

Cited by 12 publications

(16 citation statements)

References 27 publications

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“…Lynam et al ( 2011 ) identify that a central, yet often unexamined, assumption of primary health care is that families have the knowledge, skills and resources to navigate the health-care system, follow through on referrals, enact recommended treatment, and clearly present their concerns about their child to health-care providers in order to initiate treatment. However, in the context of vulnerabilities that arise out of social, material and historical circumstances, many parents are not “confident advocates” for their children, or parents may recognize a need for support for their child but their ability to act on the need is constrained by a number of factors, including a lack of knowledge of child development, health systems organization, or of their rights.…”

Section: Discussionmentioning

confidence: 99%

It takes a village: a realist synthesis of social pediatrics program

Tyler

Lynam

O’Campo

et al. 2018

Int J Public Health

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Objectives To better understand how social pediatric initiatives (SPIs) enact equitable, integrated, embedded approaches with high-needs children and families while facilitating proportionate distribution of health resources. Methods The realist review method incorporated the following steps: (1) identifying the review question, (2) formulating the initial theory, (3) searching for primary studies, (4) selecting and appraising study quality, (5) synthesizing relevant data and (6) refining the theory. Results Our analysis identified four consistent patterns of care that may be effective in social pediatrics: (1) horizontal partnerships based on willingness to share status and power; (2) bridged trust initiated through previously established third party relationships; (3) knowledge support increasing providers’ confidence and skills for engaging community; and (4) increasing vulnerable families’ self-reliance through empowerment strategies. Conclusions This research is unique because it focused on “how” outcomes are achieved and offers insight into the knowledge, skills and philosophical orientation clinicians need to effectively deliver care in SPIs. Research insights offer guidance for organizational leaders with a mandate to address child and youth health inequities and may be applicable to other health initiatives.

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Section: Discussionmentioning

confidence: 99%

It takes a village: a realist synthesis of social pediatrics program

Tyler

Lynam

O’Campo

et al. 2018

Int J Public Health

Self Cite

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“…CSP models have demonstrated positive results wherein children demonstrate improvements in their academic grades and overall sense of well-being. It is well-documented children facing social disparities, trauma and toxic stress will experience a disproportionate number of negative physical and mental health outcomes across their lifespan [6,26-29].…”

Section: Discussionmentioning

confidence: 99%

“…More specifically, children and families from vulnerable populations may not have the skills to confidently navigate the healthcare system even if they recognize a need for support. This is often due to a lack of knowledge in their rights, healthcare systems, and even normal child development [6]. Factors like low SES may be mediating delays in diagnoses for these vulnerable families, resulting in even poorer outcomes for the child.…”

Section: Introductionmentioning

confidence: 99%

Examining the Importance of Family History in Pediatric Behavioural Referrals

Gander

Campbell

Flood

et al. 2019

Cureus

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In recent years, there has been a substantial increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Without appropriate management of symptoms and care, ADHD has been associated with a variety of negative child and adult outcomes. Environmental and familial factors that may contribute to three different pediatric referral types (academic, behavioural, and attentional) associated with ADHD were examined in the current study. In total, data from 477 families who were interviewed as a part of the intake process to a pediatric clinic were included in this study. Data for the current study was extracted from the intake questionnaires and included information on family history of mental health issues, socioeconomic status, and family relationships. The sample included children between the ages of three and 17 and mostly comprised males ( n = 340). A frequency analysis of the data demonstrated relatively high rates of mental health issues within families (61.4%); almost half of the mothers reported some post-secondary education (46.1%) and most reported having normal relationships with their children (mothers, 78%; fathers, 62.9%). Finally, three stepwise regression analyses were conducted to predict referral type. All three regressions yielded significant models. Fifteen percent of the variability of the academic referral type was predicted by being male, age at the time of referral, mother’s education level, and mother’s learning. The behavioural referral types were predicted by a family history of depression, being male, mother-child relationship, and age at the time of referral; these accounted for 23% of the variance. Attentional referral type was predicted only by mother-child relationship that captured 6% of the variance. Overall, this study describes a population of parents of children with academic, behavioural, and attention-related referrals to pediatrics. Results indicate that mothers have a profound influence on their child’s referral types, something that may transfer into later diagnosis and perhaps prognosis. Clinicians and researchers alike should focus their efforts toward developing integrative service assessment and treatment approaches that include important people in the child’s life. The implementation of Community Social Pediatrics (a streamlined, inclusive approach to care) should be considered in urban centres like this one, where referrals like this are prevalent.

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“…Social Pediatrics is an interdisciplinary community-based approach that builds supportive relationships between healthcare providers and community services for children and their families. [1] Health encompasses physical health and the social determinants of health. Health and community services are integrated to accommodate natural transitions across the developmental lifespan from early childhood to young adulthood.…”

Section: Introductionmentioning

confidence: 99%

“…The first of its kind in Canada, this social pediatric nursing initiative was known as Responsive Intersectoral Children's Health Education, and Research (RICHER). [1] The RICHER initiative expanded to community centers, daycares and non-profit family support sites within our province. A key feature of RICHER is the use of nurse practitioners to provide clinical services and make necessary referrals for further assessment and care (e.g., dental, nutrition, audiology).…”

Section: Introducing the Richer Modelmentioning

confidence: 99%

Social pediatrics in a baccalaureate nursing curriculum

Dhari

MacPhee²,

Pixton³

2021

JNEP

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This paper describes the use of social pediatrics in one baccalaureate nursing curriculum. Social pediatrics is a conceptual model that considers health as physical health and the social determinants of health. Social pediatrics focuses on community-based primary healthcare services for at-risk children and their families. The social pediatrics model is used by community early childhood education StrongStart sites in one Canadian province; these sites are collaborations between early childhood educators and public health nursing teams for children from infancy through five years of age. Acute care clinical placements are becoming too complex and limited in number to accommodate large undergraduate nursing cohorts. Our undergraduate nursing program recently shifted acute care pediatric placements to StrongStart sites, combining community pediatric and public health nursing learning objectives and learning activities that foreground social pediatrics. The acute care component of pediatric nursing includes classroom theory, clinical laboratory and virtual simulations. This paper describes social pediatrics integration within our undergraduate curriculum between 2018-2019; and a qualitative evaluation of our social pediatrics approach in 2019-2020. We used content analysis to identify common themes from interviews with key actors, including students’ clinical instructors, StrongStart sites’ early childhood educators and managers, and public health nurse managers affiliated with StrongStart sites. Common themes were related to social pediatrics learning opportunities and drawbacks; social pediatrics knowledge, skills and attitudes; and recommendations for curriculum enhancement.

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The RICHER Social Pediatrics Model: Fostering Access and Reducing Inequities in Children's Health

Cited by 12 publications

References 27 publications

It takes a village: a realist synthesis of social pediatrics program

It takes a village: a realist synthesis of social pediatrics program

Examining the Importance of Family History in Pediatric Behavioural Referrals

Social pediatrics in a baccalaureate nursing curriculum

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