abstract: 'OBJECTIVE: Children of color and from low-income families experience

  disparities in hospital care and outcomes. This study examined the

  experiences of parents and providers who participated in a novel patient

  navigation program designed to address these disparities. METHODS:

  Between April and October 2018, we conducted semistructured interviews

  with parents enrolled in the Family Bridge navigation pilot study, and

  inpatient care providers. Each set of interviews was thematically coded

  and analyzed according to the Realist Evaluation Framework of context,

  mechanism and outcomes; to identify how and when the pro-gram worked,

  for whom, and with what results. RESULTS: Of 60 parents enrolled in the

  intervention, 50 (83\%) completed an interview. All enrolled children

  had public insurance; 66\% were Hispanic, 24\% were non -His-panic

  Black, and 36\% of parents preferred Spanish for communication. Of 23

  providers who completed an inter-view, 16 (70\%) were attending

  physicians. Parents identified 4 contexts influencing intervention

  effectiveness: past clinical experience, barriers to communication,

  access to resources, and timing of intervention delivery. Four

  mechanisms were identified by both parents and providers: emotional

  support, information collection and sharing, facilitating communication,

  and addressing unmet social needs. Parent-level outcomes included

  improved communication, feeling supported, and increased parental

  knowledge surrounding the child''s care and the health system.

  Provider-level outcomes included providing tailored communication and

  attending to family nonmedical needs. CONCLUSIONS: This study provided

  insight into the mechanisms by which an inpatient navigation program may

  improve communication, support, and knowledge for parents of low-income

  children of color, both directly and by changing provider behavior.'
affiliation: 'Chisholm, H (Corresponding Author), Yale Univ, Sch Publ Hlth, Dept Social
  \& Behav Sci, 60 Coll St, New Haven, CT 06510 USA.

  Chisholm, Hillary; Kershaw, Trace, Yale Univ, Sch Publ Hlth, Dept Social \& Behav
  Sci, 60 Coll St, New Haven, CT 06510 USA.

  Chisholm, Hillary, MGH Inst Hlth Profess, Sch Nursing, Boston, MA USA.

  Guerra, Laura Sotelo; Bocek, Kevin; Garcia, Yesenia; Lion, K. Casey, Seattle Childrens
  Res Inst, Ctr Child Hlth Behav \& Dev, Seattle, WA USA.

  Lion, K. Casey, Univ Washington, Seattle Childrens Hosp, Dept Pediat, Sch Med, Seattle,
  WA USA.'
author: Chisholm, Hillary and Kershaw, Trace and Guerra, Laura Sotelo and Bocek, Kevin
  and Garcia, Yesenia and Lion, K. Casey
author-email: hchisholm@mghihp.edu
author_list:
- family: Chisholm
  given: Hillary
- family: Kershaw
  given: Trace
- family: Guerra
  given: Laura Sotelo
- family: Bocek
  given: Kevin
- family: Garcia
  given: Yesenia
- family: Lion
  given: K. Casey
da: '2023-09-28'
eissn: 1876-2867
files: []
issn: 1876-2859
journal: ACADEMIC PEDIATRICS
keywords: 'emotional support; low-income/minority; patient-centered communication;

  patient navigation; pediatric hospital medicine'
keywords-plus: CARE
language: English
month: JUL
number: '5'
number-of-cited-references: '26'
pages: 789-796
papis_id: 5a48ade4e8ea1fbd7882ce0c5807c10f
ref: Chisholm2021realistevaluation
times-cited: '0'
title: A Realist Evaluation Analysis of a Novel Multi-Faceted Inpatient Patient Navigation
  Program
type: article
unique-id: WOS:000885960300006
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '22'
web-of-science-categories: Pediatrics
year: '2021'