학술논문
Qualitative Study of Barriers and Facilitators to Care Among Children in Immigrant Families.
Document Type
Academic Journal
Author
Masciale M; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; DiValerio Gibbs K; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Asaithambi R; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Murillo MC; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Espinoza-Candelaria G; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.; Jaramillo M; Department of Neurology, Johns Hopkins, Baltimore, Maryland.; Domínguez J; Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts.; Haq H; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Fredricks K; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Lopez MA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Center for Child Health Policy and Advocacy, Texas Children's Hospital, Houston, Texas.; Bocchini C; Department of Pediatrics, Baylor College of Medicine, Houston, Texas.; Center for Child Health Policy and Advocacy, Texas Children's Hospital, Houston, Texas.
Source
Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 101585349 Publication Model: Print Cited Medium: Internet ISSN: 2154-1671 (Electronic) Linking ISSN: 21541671 NLM ISO Abbreviation: Hosp Pediatr Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Children in immigrant families comprise ∼25% of US children and live in families with high levels of poverty and food insecurity. Studies suggest a decline in public benefit enrollment among children in immigrant families. We aimed to explore perspectives on barriers and facilitators in accessing care among immigrant caregivers of hospitalized children.
Methods: With a general qualitative descriptive design, we developed a semistructured interview guide using an iterative process informed by literature and content expertise. Using purposive sampling, we recruited immigrant caregivers of hospitalized children in March 2020 and conducted interviews in English or Spanish. Interviews were recorded, transcribed, and translated to English. Three authors coded transcripts using Dedoose and identified themes via thematic analysis.
Results: Analysis of 12 caregiver interviews revealed barriers and facilitators in accessing healthcare and public benefit use. Barriers included healthcare system barriers, immigration-related fear, and racism and discrimination. Within healthcare system barriers, subthemes included language barriers, cost, complexity of resource application, and lack of guidance on available benefits. Within immigration-related fear, subthemes included fear of familial separation, fear of deportation, fear that benefit use affects immigration status, and provider distrust. Healthcare system facilitators of resource use included recruiting diverse workforces, utilizing language interpretation, guidance on benefit enrollment, legal services, and mental health services. Participants also recommended hospital partnership with trusted information sources, including media stations and low-cost clinics.
Conclusions: Immigrant caregivers of hospitalized children identified barriers and facilitators in access to care. Further research is needed to assess the efficacy of caregiver-suggested interventions.
(Copyright © 2023 by the American Academy of Pediatrics.)
Methods: With a general qualitative descriptive design, we developed a semistructured interview guide using an iterative process informed by literature and content expertise. Using purposive sampling, we recruited immigrant caregivers of hospitalized children in March 2020 and conducted interviews in English or Spanish. Interviews were recorded, transcribed, and translated to English. Three authors coded transcripts using Dedoose and identified themes via thematic analysis.
Results: Analysis of 12 caregiver interviews revealed barriers and facilitators in accessing healthcare and public benefit use. Barriers included healthcare system barriers, immigration-related fear, and racism and discrimination. Within healthcare system barriers, subthemes included language barriers, cost, complexity of resource application, and lack of guidance on available benefits. Within immigration-related fear, subthemes included fear of familial separation, fear of deportation, fear that benefit use affects immigration status, and provider distrust. Healthcare system facilitators of resource use included recruiting diverse workforces, utilizing language interpretation, guidance on benefit enrollment, legal services, and mental health services. Participants also recommended hospital partnership with trusted information sources, including media stations and low-cost clinics.
Conclusions: Immigrant caregivers of hospitalized children identified barriers and facilitators in access to care. Further research is needed to assess the efficacy of caregiver-suggested interventions.
(Copyright © 2023 by the American Academy of Pediatrics.)