Parents in the focus groups cited a broad range of social stressors that affected their childrenís health and well-being, including some that screening tools for social determinants of health may not currently include.
Parents in the focus groups were first asked what they worry about or find most challenging when it comes to their childrenís health and well-being. The groups began this way to ground the subsequent conversation in the parentsí own concerns and to find out how these concerns compared to the social determinants of health for which some pediatricians are screening.
In response, parents in the groups raised many factors they believe affected their children currently and which, they worried, might affect them in the future. Parents seemed acutely aware of the impact of these stressors on their children and often described first-hand experiences with them in their own lives or the lives of friends and family.FINDING 2. WHAT ROLES DID THESE PARENTS THINK PEDIATRICIANS COULD PLAY IN ADDRESSING SOCIAL NEEDS?
Parents who had sought help from community organizations and other social service providers valued the support they received.
Some of the parents in the focus groupsóincluding both those in the groups conducted onsite at community organizations and those in the groups conducted at the focus group facilityóreported turning to community organizations and other social service providers for help with the issues that worried them or that they found challenging. The parents who had sought such help generally valued it.FINDING 3. WHY DID PARENTS THINK DISCUSSING THE MORE SENSITIVE SOCIAL NEEDS WITH PEDIATRICIANS WOULD BE DIFFICULT?
Parentsí concerns about discussing sensitive social needs with pediatricians included worries about being judged and discriminated against, fear of intervention by a child welfare agency, lack of time during appointments and frustration at the prospect of disclosing sensitive information without getting help.
For most parents in these groups, the idea of discussing social stressors with pediatricians was unfamiliar. They generally understood why pediatricians would be asking about these stressors, but many emphasized the need for them to approach the topics with sensitivity. Furthermore, the prospect of discussing some social stressors provoked wariness among most parents.
The focus group moderators sought to understand parentsí concerns so pediatricians could understand and address them. The final section of this report details parentsí ideas for how pediatricians can approach these discussions in ways that are productive and welcoming for parents and families.FINDING 4. HOW DID THESE PARENTS THINK PEDIATRICIANS SHOULD DISCUSS SOCIAL DETERMINANTS OF HEALTH WITH THEM?
Parentsí recommendations for pediatricians about discussing social determinants of health included building trust, choosing the right moment and making clear that screening is standard protocol.
Despite the concerns they cited about discussing social needs with pediatricians, particularly their more sensitive needs, most parents in these groups responded enthusiastically when the moderators asked for their ideas about how pediatricians should approach discussing social determinants of health.