Caballero Tania Maria, Bevilacqua Kristin, Polk Sarah
Department of Pediatrics | Centro S.O.L. - Center for Salud/Health and Opportunity for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Qual Health Res. 2025 May 23:10497323251336577. doi: 10.1177/10497323251336577.
Many immigrants lose healthcare access postpartum including contraceptive methods and management. Community health centers (CHCs) fill gaps in preventive healthcare access for uninsured, but the transition from hospital to community settings for immigrants is complex and not well described. While parental healthcare access diminishes postpartum, infants have frequent pediatric visits during the first year of life. The pediatric office can offer a family-centered approach to care for immigrant parents with diverse cultural backgrounds and lived experiences. Our primary study goal was to describe family planning navigation experiences among recently postpartum immigrant Latine with contraceptive needs using the Levesque conceptual framework of healthcare access. Our secondary goal was to explore the perception of the pediatrician in family planning navigation. We conducted semi-structured interviews in Spanish with 19 mothers at an urban pediatric practice. Our results centered around five themes: there is no standard process of obtaining information about CHCs postpartum; the pediatrician is a trusted information source, but displacing time for child-focused needs is a concern; structural barriers impede family planning goals; lack of health insurance affects autonomy in contraceptive decision making; and CHC care is satisfactory when accessible. Postpartum Latine immigrants receive inconsistent information about CHC resources for family planning and face barriers to their contraceptive goals. Pediatricians are considered trusted sources for family planning information. Bridging gaps in contraceptive access can include up-to-date CHC resources, resource navigators, interventions in pediatric settings, and broader insurance coverage.
许多移民在产后失去了包括避孕方法和管理在内的医疗保健服务。社区卫生中心（CHC）填补了未参保者预防性医疗保健服务的空白，但移民从医院过渡到社区环境的过程很复杂，且描述得并不充分。虽然产后父母获得医疗保健服务的机会减少，但婴儿在出生后的第一年需要频繁进行儿科就诊。儿科诊所可以为具有不同文化背景和生活经历的移民父母提供以家庭为中心的护理。我们的主要研究目标是使用Levesque的医疗保健服务可及性概念框架，描述近期产后有避孕需求的拉丁裔移民在计划生育导航方面的经历。我们的次要目标是探讨儿科医生在计划生育导航方面的看法。我们在一家城市儿科诊所对19位母亲进行了西班牙语的半结构化访谈。我们的结果围绕五个主题展开：产后获取社区卫生中心信息没有标准流程；儿科医生是可信赖的信息来源，但为关注儿童的需求挤出时间令人担忧；结构性障碍阻碍计划生育目标；缺乏医疗保险影响避孕决策的自主性；当能够获得服务时，社区卫生中心的护理令人满意。产后拉丁裔移民在获得计划生育社区卫生中心资源的信息方面存在不一致的情况，并且在实现避孕目标时面临障碍。儿科医生被认为是计划生育信息的可信赖来源。弥合避孕服务获取方面的差距可以包括最新的社区卫生中心资源、资源导航员、儿科环境中的干预措施以及更广泛的保险覆盖范围。
