Seeking Optimal, Integrated Pediatric Medical and Social Care: A Qualitative, Peer Researcher-Driven Study

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-03-13 DOI:10.1016/j.acap.2025.102816

Margaret N. Jones MD, MS , Clare Heaney BS , Jessica Obayan LMSW , Daniela Vollmer MSc , Monica Arenas MPH , Malika Muhammad C-CHW , Raffel Prophett MA , Patricia White EdD , Moshe Seid BS , Elizabeth B. Quinonez MHA, PMP, CHES , Lauren Lipps MA , Adrienne W. Henize JD , Ndidi I. Unaka MD, MEd , Andrew F. Beck MD, MPH , on behalf of the Responding to Identified Sociomedical risks with Effective Unified Purpose Team (full team listed in Acknowledgments section)

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引用次数: 0

Abstract

Objective

To generate qualitative insights with patients, families, and community partners to catalyze nimble, aligned medical-social care responses.

Methods

This study employed qualitative and co-design methods. We partnered with 4 peer researchers who interviewed individuals living in Greater Cincinnati with recent experience as pediatric patients or caregivers of pediatric patients. Interviews assessed ways in which health care, human services, patients, families, and communities do (or do not) collaborate to provide medical-social care. Interview transcripts were independently reviewed by an analytic team, inclusive of peer researchers, co-design experts, and pediatric clinicians and researchers. Findings were validated during community discussions, facilitating identification of themes and opportunity areas for intervention.

Results

Peer researchers conducted 19 interviews (14 English and 5 Spanish). Interviewees included individuals ranging from young adults (recent patients) to older adults with lived experience as caregivers of pediatric patients. Most identified as minority race and ethnicity and lived in socioeconomically disadvantaged Cincinnati neighborhoods. Themes related to structural barriers included 1) services are difficult to navigate; 2) medical and social care are often reactive (or nonexistent) when they could be proactive; and 3) medical and social care could be more closely integrated. Themes related to human factors included 4) medical and social service institutions are often untrustworthy; 5) diversified care teams with shared lived experiences could improve care delivery; and 6) optimal care requires empathy, clear communication, and partnership.

Conclusions

Patients, families, and community members identified themes and opportunity areas for improving medical and social care delivery. Next steps include the implementation and evaluation of prototype interventions.

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寻求最佳的，综合儿科医疗和社会护理：一项定性的，同行研究者驱动的研究。

目的：与患者，家庭和社区合作伙伴产生定性见解，以催化灵活，一致的医疗-社会护理反应。方法：本研究采用定性和协同设计方法。我们与4位同行研究人员合作他们采访了居住在大辛辛那提地区的近期有儿科患者或儿科患者看护经验的人。访谈评估了卫生保健、人类服务、患者、家庭和社区合作（或不合作）提供医疗社会保健的方式。访谈记录由包括同行研究人员、共同设计专家、儿科临床医生和研究人员在内的分析团队独立审查。在社区讨论中验证了调查结果，促进了主题和干预机会领域的确定。结果：同行研究者共进行了19次访谈（英语14次，西班牙语5次）。受访者包括从年轻人（最近的病人）到老年人的生活经验，作为儿科病人的照顾者。大多数被认为是少数族裔，生活在辛辛那提的社会经济弱势社区。与结构性障碍相关的主题包括：1)服务难以驾驭；2)医疗和社会关怀往往是被动的（或不存在），当他们可以主动；3)医疗和社会保健可以更紧密地结合起来。与人为因素相关的主题包括：4)医疗和社会服务机构往往不值得信任；5)共享生活经验的多元化护理团队可以改善护理服务；最佳的护理需要移情、清晰的沟通和合作。结论：患者、家属和社区成员确定了改善医疗和社会保健服务的主题和机会领域。接下来的步骤包括实施和评估原型干预措施。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.