Parent activation and pediatric primary care outcomes for vulnerable children: A mixed methods study. Issue 12 (December 2019)

• Record Type: Journal Article
• Authors: DeCamp, Lisa Ross; Showell, Nakiya; Godage, Sashini K.; Leifheit, Kathryn M.; Valenzuela-Araujo, Doris; Shah, Harita; Polk, Sarah
• Is Part Of: Patient education and counseling. Volume 102:Issue 12(2019)
• Page Start: 2254
• Page End: 2262
• Publication Date: 2019-12
• Subjects: Pediatrics -- Patient engagement -- Limited English proficiency -- Primary care -- Latino -- Disparities -- Vulnerable populations; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2019.07.004
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Few associations between parent activation and pediatric primary care outcomes. No association between activation and outcomes for English-speaking parents. Activation associated with child weight & health status for Spanish-speakers. Parent interviews enrich understanding of limited activation relation with outcomes. System barriers, question wording & language/culture affect activation measurement. Abstract: Objective: Among children in low-income families 1) examine associations between parent activation and pediatric primary care outcomes and 2) explore parent perspectives on Parent-Patient Activation Measure (P-PAM) questions in relation to pediatric primary care experiences. Methods: We examined associations between P-PAM score via Spanish- or English-language survey and healthcare outcomes abstracted from electronic medical records for parent/child dyads at an urban general pediatrics clinic. Parent perspectives were elicited via qualitative interviews with a subsample of parents who "thought aloud" during P-PAM completion. Results: Among 316 Spanish (68%) and English-language parent/child dyads, we found associations between parent activation and primary care outcomes only among Spanish-language dyads and only for weight and health status. Findings from 21 interviews provided possible explanations for quantitative findings including question limitations in assessing knowledge, skills, and confidence in pediatric primary care and P-PAM cultural and linguistic appropriateness for low-income Latino populations. Conclusions: Pairing quantitative and qualitative methods provided insight on P-PAM measurement limitations and raised questions about its use in patient engagement interventions to reduce health disparities. Practice implications: Practices serving vulnerable children and families should consider the limitations of the P-PAM for measuring parent healthcare engagement before utilizing the P-PAM in patient engagement interventions.