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Urban, Low-Income, African American Parents' Experiences and Expectations of Well-Child Care
Kara S Koschmann1, Cynthia J Peden-McAlpine2, Mary Chesney2
1St. Catherine University, 2004 Randolph Ave., MN, United States of America.
Insights
Low-income African American parents desire trusted relationships with pediatric providers for better well-child care. Understanding community and system challenges is key to improving pediatric health equity.
Area of Science:
- Pediatric Health
- Health Equity
- Social Determinants of Health
Background:
- Well-child care is crucial for pediatric health promotion and disease prevention.
- Healthcare disparities exist, with lower quality care for low-income and African American children.
- Social determinants significantly impact child health outcomes.
Purpose of the Study:
- To understand the well-child care experiences and expectations of urban, low-income, African American parents.
- To identify how high-quality well-child care can mitigate negative social determinants on child health.
- To inform strategies for improving pediatric care quality for underserved populations.
Main Methods:
- Qualitative focus group method with purposive sampling.
- Recruited low-income, African American parents with children aged 0-5 years.
- Inductive content analysis of transcribed focus group data.
Main Results:
- Key themes included community factors, sources of parenting advice, system challenges (cost, provider continuity), and provider interactions.
- Parents reported challenges such as providers not listening or treating them differently.
- Parents expressed a desire for providers who know and trust them.
Conclusions:
- Study highlights contexts contributing to healthcare disparities in pediatric care.
- Findings offer insights into parents' healthcare behaviors and expectations.
- Results guide providers in delivering culturally competent well-child care to improve child health outcomes.
Purpose:
Well-child care is the foundation of pediatric health promotion and disease prevention. Primary care quality is lower for low-income and African American children compared to white children, and social determinants have an increasingly acknowledged impact on child health. Ensuring that high-quality well-child care fulfills its potential to mitigate the negative effects of social determinants on African American children is imperative. This study provides an understanding of urban, low-income, African American well-child care experiences and expectations.
Design And Methods:
A qualitative, focus group method was used. A purposive, volunteer sample of low-income, African American parents with children birth to age five was recruited from St. Louis and Milwaukee. Focus groups were held in convenient, community sites. Data was audio-digitally recorded. Transcribed data were coded and analyzed through inductive content analysis.
Results:
Thirty-five caregivers, 86% females, participated in four focus groups. Categories (and sub-categories) identified include: Community factors (We want better schools, It's getting more rough where I live); Sources of parenting advice (Google it, Call your parent, Older remedies); System challenges (Cost, Frequent new faces, Politics); Challenges with providers (Couldn't help me, Missed something important, Treated differently, Are you really listening?); Anticipatory guidance (Breastfeeding, Discipline, Vaccines, Development); and What parents desire (Know them, trust).
Conclusions:
This study reveals the contexts that give rise to health care disparities and provides insight into parent's healthcare behaviors.
Practice Implications:
Results offer providers guidance in providing well-child care for this population to improve pediatric care quality and child health.
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