Group Well-Child Care Model for Latino Children in Immigrant Families: Adapting to and Learning From the Coronavirus Disease 2019 (COVID-19) Context

FAMILIES SYSTEMS & HEALTH(2022)

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摘要
Public Significance Statement This study suggests that virtual pediatric group well-child care (GWCC) was generally acceptable and a source of social support for Spanish speaking Latina mothers in the initial phase of the COVID-19 pandemic. Mothers and pediatric providers generated a list of recommendations to improve feasibility, privacy, and address sustainability of GWCC. Introduction: Group well-child care (GWCC) is an alternative to traditional pediatric well-child care designed to increase parental social support and peer learning. This mixed methods study explored the adaptation and implementation of GWCC to a virtual format during coronavirus disease 2019 (COVID-19 pandemic) among Spanish-speaking Latino immigrant families. Method: Interviews were conducted with eight providers and 10 mothers from May through September 2020. Qualitative analyses used a priori codes based on an implementation science framework. Quantitative data included demographics, the COVID-19 Impact Scale, and virtual group attendance. Bivariate analyses identified correlates of virtual visit attendance. Results: Eighty percent of mothers reported the pandemic had moderately or extremely impacted at least one major life domain such as daily life, food security, or family conflict. Of 27 mothers offered virtual groups, 67% attended. Mothers who attended virtual groups reported lower English proficiency (p = .087) and fewer friends and family members with COVID-19 (M = 1.0 vs. 5.1, p < .05) than those who did not attend. Women described virtual GWCC as acceptable and a source of social support. Some described differences in group dynamics compared with in-person groups and had privacy concerns. Providers noted scheduling and billing challenges affecting feasibility and sustainability. They reported that visits with good attendance were productive. Mothers and pediatric providers offered recommendations to improve feasibility and privacy and address sustainability. Discussion: Competing demands for those most impacted by COVID-19 may outweigh benefits of attendance. Virtual Spanish language GWCC appears acceptable and feasible for Spanish speaking Latina mothers. Thematic analysis and recommendations identify areas of improvement.
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关键词
immigrant health, Latino health, pediatric integrated care, telehealth, two-generation approaches to health
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