Pediatrician Preparedness and Referrals to Resources for Children in Immigrant Families

To identify characteristics associated with (1) pediatrician preparedness to provide care for children in immigrant families (CIF) and (2) referrals to resources for health-related social needs (HRSNs).

We analyzed the 2023 American Academy of Pediatrics Periodic Survey to assess association of pediatrician and practice characteristics with (1) preparedness to care for CIF and (2) referrals for six types of HRSNs (social services, federal/state programs, early childhood development, health insurance, legal/immigration-related services, adult English language programs). After bivariate analyses identified significant modifiable practice characteristics, we conducted multivariable analyses to determine associations with: (1) pediatrician preparedness, (2) providing referrals for HRSNs, and (3) individual types of referrals.

Of 488 respondents (response rate 33%), only 49% reported feeling moderately/very prepared to care for CIF, despite having 26% CIF (on average) in their practices. Modifiable practice factors were: offering written materials in the patient's primary language, hiring bilingual/multilingual staff, having professional interpreters, and having care coordination. Factors associated with higher number of referral types were: written materials in primary language (estimated marginal mean referrals 2.94 vs 2.07, p<0.001), bilingual/multilingual staff (3.04 vs 2.46, p<0.001) and care coordination (2.85 vs 2.40, p<0.01). Modifiable characteristics were also independently associated with specific referrals, particularly to federal/state programs and social services. Factors associated with improved pediatrician preparedness were bilingual/multilingual staff [aOR 1.92 (95%CI 1.17,3.17)] and care coordination [aOR 1.89 (95%CI 1.10,3.23)].

Ensuring adequate linguistic support and dedicated care coordination may strengthen pediatrician preparedness, facilitate HRSN referrals and, ultimately, improve quality of care for CIF.