PolicyLab and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (A Vasan and CC Kenyon), Philadelphia, Pa; Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania (A Vasan and CC Kenyon), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania (A Vasan, O Darko, K Fortin, PV Scribano, and CC Kenyon), Philadelphia, Pa.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania (A Vasan, O Darko, K Fortin, PV Scribano, and CC Kenyon), Philadelphia, Pa; Children's Hospital of Philadelphia (O Darko, K Fortin, and PV Scribano), Philadelphia, Pa.
Acad Pediatr. 2022 Apr;22(3):461-469. doi: 10.1016/j.acap.2021.09.010. Epub 2021 Sep 24.
Pediatric health systems are increasingly screening caregivers for unmet social needs. However, it remains unclear how best to connect families with unmet needs to available and appropriate community resources. We aimed to explore caregivers' perceived barriers to and facilitators of community resource connection.
We conducted semistructured interviews with caregivers of pediatric patients admitted to one inpatient unit of an academic quaternary care children's hospital. All caregivers who screened positive for one or more unmet social needs on a tablet-based screener were invited to participate in an interview. Interviews were recorded, transcribed, and coded by 2 independent coders using content analysis, resolving discrepancies by consensus. Interviews continued until thematic saturation was achieved.
We interviewed 28 of 31 eligible caregivers. Four primary themes emerged. First, caregivers of children with complex chronic conditions felt that competing priorities related to their children's medical care often made it more challenging to establish connection with resources. Second, caregivers cited burdensome application and enrollment processes as a barrier to resource connection. Third, caregivers expressed a preference for geographically tailored, web-based resources, rather than paper resources. Last, caregivers expressed a desire for ongoing longitudinal support in establishing and maintaining connections with community resources after their child's hospital discharge.
Pediatric caregivers with unmet social needs reported competing priorities and burdensome application processes as barriers to resource connection. Electronic resources can help caregivers identify locally available services, but longitudinal supports may also be needed to ensure caregivers can establish and maintain linkages with these services.
儿科卫生系统越来越多地对照顾者进行未满足的社会需求筛查。然而，如何将有未满足需求的家庭与可用的和适当的社区资源联系起来仍然不清楚。我们旨在探讨照顾者对社区资源联系的感知障碍和促进因素。
我们对在一家学术四级儿童保健医院的一个住院病房住院的儿科患者的照顾者进行了半结构式访谈。所有在基于平板电脑的筛查器上筛查出一个或多个未满足的社会需求呈阳性的照顾者都被邀请参加访谈。访谈由 2 位独立的编码员使用内容分析进行记录、转录和编码，通过共识解决差异。访谈继续进行，直到达到主题饱和。
我们采访了 31 位符合条件的照顾者中的 28 位。出现了四个主要主题。首先，患有复杂慢性疾病的儿童的照顾者认为，与儿童医疗保健相关的优先事项相互竞争，这使得与资源建立联系更加具有挑战性。其次，照顾者提到繁琐的申请和注册流程是资源联系的障碍。第三，照顾者表示更喜欢针对特定地理位置的、基于网络的资源，而不是纸质资源。最后，照顾者表示希望在孩子出院后与社区资源建立和维持联系时，能得到持续的纵向支持。
有未满足社会需求的儿科照顾者报告说，优先事项相互竞争和繁琐的申请流程是资源联系的障碍。电子资源可以帮助照顾者识别当地可用的服务，但可能还需要长期支持，以确保照顾者能够建立和维持与这些服务的联系。
