The Path to Partnership: Improving Family Engagement Strategies in the North Carolina Integrated Care for Kids Model

Pediatric care management has the potential to streamline care delivery across fragmented child-serving sectors, but successfully engaging families is challenging. This study aimed to understand barriers and facilitators to family engagement from the perspectives of care managers in a pediatric integrated service delivery model for children with health and social needs.

Three virtual focus groups were conducted with care managers from North Carolina Integrated Care for Kids (NC InCK), a federal demonstration model to integrate cross-sector care for Medicaid-enrolled children under 21 years. The focus group questions were developed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Rapid qualitative analysis methods were used for analysis.

Eleven care managers were included across 3 focus groups. Four themes emerged as follows: 1) Rapport Building Strategies; 2) Simplifying Program Detail and Providing Information One Step at a Time; 3) Firewalls-Barriers in Technology and Information; and 4) Retention: One and Done. Care managers identified several barriers to engaging families, including effectively communicating the program's benefits, building trust via cold calls, and facilitating long-term retention beyond an initial encounter. They revealed that rapport-building strategies could enhance family engagement by providing tangible resources early in the engagement and offering basic needs assistance to support the whole family, such as rent assistance.

This study illuminated barriers and facilitators to the family engagement process through the lens of care managers. Our findings support evidence to inform family engagement strategies for children with multisector needs, filling a gap in the pediatric care management literature.