Department of Pediatrics, David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
Children's Discovery & Innovation Institute, Mattel Children's Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
J Community Health. 2020 Apr;45(2):329-337. doi: 10.1007/s10900-019-00747-1.
We sought to understand the role of parent engagement in overcoming barriers to care for youth re-entering the community following incarceration. For this mixed methods study, we conducted quantitative surveys on healthcare needs and access with youth (n = 50) at 1-month post-incarceration, and semi-structured interviews with a subset of these youth (n = 27) and their parents (n = 34) at 1, 3, and 6-months post-incarceration (total 94 interviews). Differences by race/ethnicity and gender were assessed using Chi square test of proportions. We performed thematic analysis of interview transcripts to examine the role of parent engagement in influencing youths' access to healthcare during reentry. Most youth were from racial/ethnic minority groups and reported multiple ACEs. Girls, compared to boys, had higher ACE scores (p = 0.03), lower family connectedness (p = 0.03), and worse general health (p = 0.02). Youth-identified barriers to care were often parent-dependent and included lack of: affordable care (22%), transportation (16%), and accompaniment to health visits (14%). Two major themes emerged from the qualitative interviews: (1) parents motivate youth to seek healthcare during reentry and (2) parents facilitate the process of youth seeking healthcare during reentry. Parents are instrumental in linking youth to healthcare during reentry, dispelling prevailing myths that parents of incarcerated youth are inattentive and that youth do not want their help. Efforts that support and enhance parent engagement in access to care during reentry, such as by actively involving parents in pre-release healthcare planning, may create stronger linkages to care.
我们试图了解父母参与在克服障碍方面的作用,以帮助青少年在监禁后重新融入社区。这项混合方法研究,我们在青少年(n=50)监禁后 1 个月时进行了医疗需求和获得情况的定量调查,并在监禁后 1、3 和 6 个月时对这些青少年(n=27)及其父母(n=34)进行了半结构化访谈(总共 94 次访谈)。使用比例卡方检验评估了种族/民族和性别差异。我们对访谈记录进行了主题分析,以研究父母参与对影响青少年在重新融入期间获得医疗保健的作用。大多数青少年来自种族/少数族裔群体,报告了多种 ACE。与男孩相比,女孩 ACE 评分更高(p=0.03),家庭联系更差(p=0.03),一般健康状况更差(p=0.02)。青少年确定的护理障碍往往依赖于父母,包括缺乏:负担得起的护理(22%)、交通(16%)和陪同就诊(14%)。定性访谈中出现了两个主要主题:(1)父母在重新融入期间激励青少年寻求医疗保健,(2)父母在重新融入期间促进青少年寻求医疗保健的过程。父母在重新融入期间为青少年获得医疗保健提供了重要帮助,消除了普遍存在的观念,即监禁青少年的父母不关注他们,而且青少年不想得到他们的帮助。支持和加强父母在重新融入期间参与获得医疗保健的努力,例如通过积极参与青少年出狱前的医疗保健计划,可能会建立更紧密的联系。