Qualitative Study of Barriers and Facilitators to Care Among Children in Immigrant Families
Author:
Masciale Marina1, DiValerio Gibbs Karen1, Asaithambi Rathi1, Murillo Mariana Carretero1, Espinoza-Candelaria Gabriela2, Jaramillo Maria3, Domínguez José4, Haq Heather1, Fredricks Karla1, Lopez Michelle A.15, Bocchini Claire15
Affiliation:
1. aDepartment of Pediatrics, Baylor College of Medicine, Houston, Texas 2. bDepartment of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 3. cDepartment of Neurology, Johns Hopkins, Baltimore, Maryland 4. dDepartment of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts 5. eCenter for Child Health Policy and Advocacy, Texas Children’s Hospital, Houston, Texas
Abstract
OBJECTIVES
Children in immigrant families comprise ∼25% of US children and live in families with high levels of poverty and food insecurity. Studies suggest a decline in public benefit enrollment among children in immigrant families. We aimed to explore perspectives on barriers and facilitators in accessing care among immigrant caregivers of hospitalized children.
METHODS
With a general qualitative descriptive design, we developed a semistructured interview guide using an iterative process informed by literature and content expertise. Using purposive sampling, we recruited immigrant caregivers of hospitalized children in March 2020 and conducted interviews in English or Spanish. Interviews were recorded, transcribed, and translated to English. Three authors coded transcripts using Dedoose and identified themes via thematic analysis.
RESULTS
Analysis of 12 caregiver interviews revealed barriers and facilitators in accessing healthcare and public benefit use. Barriers included healthcare system barriers, immigration-related fear, and racism and discrimination. Within healthcare system barriers, subthemes included language barriers, cost, complexity of resource application, and lack of guidance on available benefits. Within immigration-related fear, subthemes included fear of familial separation, fear of deportation, fear that benefit use affects immigration status, and provider distrust. Healthcare system facilitators of resource use included recruiting diverse workforces, utilizing language interpretation, guidance on benefit enrollment, legal services, and mental health services. Participants also recommended hospital partnership with trusted information sources, including media stations and low-cost clinics.
CONCLUSIONS
Immigrant caregivers of hospitalized children identified barriers and facilitators in access to care. Further research is needed to assess the efficacy of caregiver-suggested interventions.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health
Reference37 articles.
1. Providing care for children in immigrant families;Linton;Pediatrics,2019 2. Kaiser Family Foundation. Health coverage of immigrants. Available at: https://www.kff.org/racial-equity-and-health-policy/fact-sheet/health-coverage-of-immigrants/. Accessed March 21, 2023 3. Bernstein H, Gonzalez D, Karpman M, Zuckerman S. Amid confusion over the public charge rule, immigrant families continued avoiding public benefits in 2019. Available at: https://www.urban.org/research/publication/amid-confusion-over-public-charge-rule-immigrant-families-continued-avoiding-public-benefits-2019. Accessed March 21, 2023 4. Wong T, Cha J, Villarreal-Garcia E. The impact of changes to the public charge rule on undocumented immigrants living in the U.S. Available at: http://usipc.ucsd.edu/publications/usipc-public-charge-final.pdf. Accessed March 21, 2023 5. Migration Policy Institute. Children in U.S. immigrant families; 1990-2019. Available at: https://www.migrationpolicy.org/programs/data-hub/charts/children-immigrant-families. Accessed January 6, 2023
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