EliScholar – A Digital Platform for Scholarly Publishing at Yale
Abstract
Children are vulnerable to the long-term health impacts of unmet family needs within social determinants of health like income, food security, housing, and transportation. Efforts have grown to recognize and respond to these challenges in the pediatric setting through social needs screening and other interventions. Previous research has extensively described the pediatric provider perspective on this work. However, less is known about how caregivers experience interactions surrounding social needs in the healthcare setting and which factors may influence these perceptions. To address these gaps in knowledge, this qualitative study examined semi-structured interviews of 20 caregivers who participated in a pediatric medical-legal partnership program. The author inductively coded and analyzed the data using Dedoose. Findings examined caregivers’ lived experiences navigating social needs, the impact of these underlying histories on interactions with their children’s medical providers, and factors facilitating feelings of support within the provider-caregiver relationship. In their experiences of social needs, caregivers often felt stressed, stuck, alone, and ignored. They often downplayed or withheld their challenges from providers due to fear of misjudgment as a bad parent, fear of DCF reporting, previous negative experiences, feelings of disrespect, perceived negative assumptions, and stigma. These were drivers of distrust. Continuous opportunities for engagement, displays of genuine care, and construction of partnership fostered feelings of support, trust, and comfort among caregivers. Experiences shaped both perceptions of individual providers and the healthcare system more broadly. These findings can aid pediatric providers in promoting feelings of support among families experiencing social need by informing their approach as they structure conversations, build trusting relationships, and respond to identified needs
