Health providers and payers are increasingly taking responsibility for health outcomes and population health through a variety of approaches, including screening for social determinants of health. Just as pediatricians need time and training to integrate these screenings into their practices, parents may not necessarily expect to discuss social needs with pediatricians when they take their children to them for care.
Before designing the focus group moderator guide, Public Agenda staff reviewed previous research about social determinants of health in pediatric care, conducted eight interviews with pediatric primary care practitioners, and consulted staff at the community organizations where four of the focus groups were conducted. Researchers conducted eight focus groups in New York City of low-income parents of children five years and younger who had experience taking their children to pediatricians.
Parents in the groups drew distinctions among different types of social stressors. They could envision themselves being comfortable talking about certain issues like food and nutrition, child care, or reading to a child. But parents identified some issues, including domestic violence, immigration status, major child behavioral issues, parent mental health, and drug and alcohol use, as particularly sensitive. The parents expressed some concerns about discussing these needs:
- Parents worried about being judged and discriminated against.
- Parents feared that sharing information could trigger intervention by a child welfare agency.
- Short appointments and long waits could make it difficult for parents to discuss complex problems.
- Disclosing sensitive information without getting help might frustrate parents.
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