Parents’ Perspectives on Early Relational Health: A Qualitative Study

Access: Institutional Access

Publication year

2024

study description

Qualitative study

core topic(s)

Early Literacy , Early Relational Health , Pediatric Primary Care , Reach Out and Read (ROR) , Shared Reading

Population Characteristics

Kindergarten , Medical Providers , Race, Ethnicity, and Culture

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Implementation and Evaluation , Parent-Provider Relationships/Interactions

objectives

The American Academy of Pediatrics endorses a paradigm shift toward promoting early relational health (ERH) in pediatrics. Pediatric clinicians have a unique opportunity to promote ERH, yet little work has sought parents' perspectives on how clinicians can do so effectively. We sought to understand diverse parents' perspectives on ERH and the role of pediatric clinicians in supporting it.

exposure

Early relational health

outcomes evaluated

ERH and the role of pediatric clinicians in supporting it

setting

Middlesex County, NJ, and the surrounding area

methods

We conducted virtual focus groups using a guide prepared with input from community partners and parent advisors. We purposively sampled a diverse group of parents of children aged ≤7 years. Focus groups were recorded and transcribed verbatim. We analyzed data as it was collected and identified themes using an inductive and iterative process.

sample size

N=37 parents

measures

Focus group: to understand diverse parents’ perspectives on ERH and the role of pediatric clinicians in supporting it.

results

Thirty-seven parents participated in 8 focus groups (median parent age: 36.0 years; 43.2% Asian, 18.9% Black/African-American; 32.4% Hispanic/Latino; 78.4% mothers). We identified 3 organizing themes: (1) Time, attention, and open communication with children lay a foundation for ERH; (2) Pediatric clinicians have an opportunity to promote ERH, but disconnected parent-clinician relationships are a major barrier; and (3) Enhanced communication and careful attention to child development and family well-being represent key opportunities to strengthen parent-clinician relationships.

conclusions

Parents identified time, attention, and open communication as essential to ERH. Although participants expressed openness to clinicians addressing ERH, such work is contingent on strong parent-clinician relationships. Policymakers and clinicians seeking to address ERH in pediatric settings must also be prepared to address potential barriers through strategies like providing adequate time to facilitate relationship-building and careful attention to address this critical topic.

limitations

We purposively sampled participants from a largely urbanized location in 1 state with children younger than 7 years, so findings might not transfer to other settings and developmental stages. Future work might examine to what extent these findings transfer to other populations and geographic regions. In addition, although we sought to explore the perspectives of a diverse group of caregivers, there were still some limitations to the diversity achieved.