2023-09-28 14:46:10 +00:00
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abstract: 'OBJECTIVE: Children of color and from low-income families experience
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disparities in hospital care and outcomes. This study examined the
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experiences of parents and providers who participated in a novel patient
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navigation program designed to address these disparities.
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METHODS: Between April and October 2018, we conducted semistructured
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interviews with parents enrolled in the Family Bridge navigation pilot
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study, and inpatient care providers. Each set of interviews was
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thematically coded and analyzed according to the Realist Evaluation
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Framework of context, mechanism and outcomes; to identify how and when
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the program worked, for whom, and with what results.
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RESULTS: Of 60 parents enrolled in the intervention, 50 (83\%) completed
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an interview. All enrolled children had public insurance; 66\% were
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Hispanic, 24\% were non-Hispanic Black, and 36\% of parents preferred
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Spanish for communication. Of 23 providers who completed an interview,
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16 (70\%) were attending physicians. Parents identified 4 contexts
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influencing intervention effectiveness: past clinical experience,
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barriers to communication, access to resources, and timing of
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intervention delivery. Four mechanisms were identified by both parents
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and providers: emotional support, information collection and sharing,
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facilitating communication, and addressing unmet social needs.
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Parent-level outcomes included improved communication, feeling
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supported, and increased parental knowledge surrounding the child''s care
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and the health system. Provider-level outcomes included providing
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tailored communication and attending to family nonmedical needs.
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CONCLUSIONS: This study provided insight into the mechanisms by which an
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inpatient navigation program may improve communication, support, and
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knowledge for parents of low-income children of color, both directly and
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by changing provider behavior.'
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affiliation: 'Chisholm, H (Corresponding Author), Yale Univ, Sch Publ Hlth, Dept Social
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\& Behav Sci, 60 Coll St, New Haven, CT 06510 USA.
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Chisholm, Hillary; Kershaw, Trace, Yale Univ, Sch Publ Hlth, Dept Social \& Behav
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Sci, 60 Coll St, New Haven, CT 06510 USA.
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Chisholm, Hillary, MGH Inst Hlth Profess, Sch Nursing, Boston, MA USA.
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Guerra, Laura Sotelo; Bocek, Kevin; Garcia, Yesenia; Lion, K. Casey, Seattle Childrens
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Res Inst, Ctr Child Hlth Behav \& Dev, Seattle, WA USA.
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Lion, K. Casey, Univ Washington, Seattle Childrens Hosp, Dept Pediat, Sch Med, Seattle,
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WA USA.'
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author: Chisholm, Hillary and Kershaw, Trace and Guerra, Laura Sotelo and Bocek, Kevin
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and Garcia, Yesenia and Lion, K. Casey
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author-email: hchisholm@mghihp.edu
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author_list:
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- family: Chisholm
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given: Hillary
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- family: Kershaw
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given: Trace
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- family: Guerra
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given: Laura Sotelo
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- family: Bocek
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given: Kevin
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- family: Garcia
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given: Yesenia
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- family: Lion
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given: K. Casey
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da: '2023-09-28'
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eissn: 1876-2867
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files: []
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issn: 1876-2859
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journal: ACADEMIC PEDIATRICS
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keywords: 'emotional support; low-income/minority; patient-centered communication;
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patient navigation; pediatric hospital medicine'
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keywords-plus: ETHNIC DISPARITIES; CARE; HEALTH
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language: English
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month: JUL
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number: '5'
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number-of-cited-references: '26'
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orcid-numbers: 'Chisholm, Hillary/0000-0002-3946-4641
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Lion, K. Casey/0000-0002-7718-7462
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Sotelo Guerra, Laura/0000-0002-8456-8220
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Bocek, Kevin/0000-0003-3574-2429'
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pages: 789-796
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papis_id: 3d6369c6bf8bb82d48bc30dcb2249087
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ref: Chisholm2022realistevaluation
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times-cited: '1'
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title: A Realist Evaluation Analysis of a Novel Multi-Faceted Inpatient Patient Navigation
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Program
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000877504000013
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '22'
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web-of-science-categories: Pediatrics
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year: '2022'
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