Latinx Parent Voice in Pediatric Practice to Mitigate Social Determinants of Health: A Mixed-Methods Examination of Multiple Stakeholder Perspectives
*Names in bold indicate Presenter
This paper presents mixed-methods findings examining the integration of caregiver voice into pediatric healthcare services for infants during a policy moment where providers are being encouraged to discuss social determinants of health with families (Garg & Dworkin, 2016). We draw from data collected in 2018-19 as part of a larger mixed-methods study involving ten pediatric health clinics across the U.S. The study examines two pediatric healthcare innovations designed to prevent and mitigate toxic stress experienced by young children. Both healthcare innovations focus on enhancing pediatric practices to screen and provide supports centered on social determinants of health. Study data were collected in partnership with clinics in five communities in California, Florida, and Vermont. Data sources include fourteen focus groups with caregivers of young children (N = 105), clinic staff interviews (N = 51), and longitudinal assessment of predominantly Latinx families receiving care for their newborns with a battery of standardized measures of healthcare engagement (N = 741).
Based on the results of family focus groups and clinic staff interviews, the paper identifies facilitators and barriers to screening, referral, and linkage for social determinants of health in pediatric clinics (e.g., universal screening, explicit discussion of the goals of screening, rapport-building and administration by a near-peer staff member, implementation of linkage practices to support referral uptake). Survey results highlight parent perspectives about their inclusion in healthcare decision-making as well as their willingness to access systems of support in their communities. The paper explores how the integration of family voice into well-child visits and clinic flow can strengthen family-centered care at a population health level. The paper concludes by highlighting promising strategies to leverage family perspectives to inform clinic-based efforts promoting child well-being and scale up efforts to increase caregiver representation in healthcare from diverse and underrepresented populations.