Culturally informed developmental pediatric care: A qualitative study

Paediatricians deliver developmental care through surveillance, diagnosis, management, and advocacy. Although developmental concerns are among the most common reasons for paediatric visits, care in this area is complex, intersecting medical, mental health, and educational systems. Increasing international migration, persistent health inequities, and diverse cultural concepts of child development require paediatricians to build skills for culturally informed care. However, there is limited research describing how paediatricians perceive and navigate cultural factors when providing developmental care, and how current training and systems support or hinder this. This qualitative study explored paediatricians' perceptions of providing culturally informed developmental care to diverse populations.

Semi-structured interviews were conducted with paediatricians who primarily provide developmental care, to understand perceived challenges, opportunities, and educational needs. Thematic analysis of transcribed interviews used both inductive and deductive approaches.

Eighteen interviews yielded three major themes. First, cultural translation encompassed language barriers, use of interpreters, and trust-building within physician-family relationships. Second, inequity described systemic barriers faced by diverse families, power imbalances in healthcare, and the pandemic's amplification of inequities. Third, educational opportunities highlighted the value of reflective practice, immersive experiences in diverse settings, and building communities of practice to strengthen cultural competence.

Paediatricians described unique aspects of developmental care that may benefit from practice changes and curriculum reform. Enhanced training in interpreter use, multicultural health brokers, and care coordination teams is recommended. Peer mentorship from diverse colleagues may reduce stereotypes and broaden perspectives. Infrastructure to monitor and close culturally based health gaps is a critical priority for developmental paediatrics in Canada.