This report summarizes findings from eight focus groups with low-income parents of children ages five years and younger in New York City, conducted in English and Spanish by Public Agenda in July and August 2018.
Before designing the focus group moderator guide, Public Agenda staff reviewed previous research about social determinants of health in pediatric care, conducted eight interviews with pediatric primary care practitioners, and consulted staff at the community organizations where four of the focus groups were conducted.
To refine the research goals, Public Agenda staff held meetings with UHF staff, who then reviewed drafts of the focus group moderator guide. Public Agenda staff also held meetings with staff of the community organizations at which we planned to conduct the focus groups, to improve our understanding of the populations they served. Public Agenda staff created one moderator guide for use in both sets of focus groups, with flexibility to accommodate differences in emphasis and responses between them. The moderator guide was shared with the community organizations’ staffs if they requested it. During the focus groups, the moderators did not use the terms “social determinants of health” or “social needs.” Instead, they used neutral terms like “issues” or “factors.”
For four of the focus groups, participants were recruited by a professional
market research facility. Public Agenda staff moderated the groups at that facility. For the other four, participants were recruited by community organizations that are part of UHF’s Partnerships for Early Childhood Development (PECD) initiative. Public Agenda staff moderated the groups onsite at those organizations. The difference in recruitment ensured the participants would include parents who were not necessarily clients of community organizations connected with the PECD initiative. Public Agenda’s research
team collaboratively developed a coding scheme and coded the focus group transcripts using Dedoose qualitative analysis software. Since analysis of the transcripts indicated that parents’ perspectives, experiences and ideas across the two sets of focus groups were largely similar, data from all eight groups are discussed together in this report.
In total, 40 parents participated in the focus groups at the market research facility, which was in Manhattan. All participants were low-income parents of children ages five years and younger who had experience taking their children to pediatricians.10 Participants were recruited to Public Agenda’s specifications so that all were living in households at or below 250 percent of the federal
poverty level. They included residents of all five boroughs of New York City and reflected a diversity of low-income parents in terms of race and ethnicity, age, educational attainment, employment status and frequency with which they took their children to pediatricians. Four of the participants across these groups were fathers, and the rest were mothers. Grandparents were not included.
Potential participants were excluded if they worked in health care, health insurance, the pharmaceutical industry or health advocacy or if they had participated in a focus group within the previous six months.
The focus groups at the market research facility were conducted in English and lasted two hours. All participants were compensated for their time and provided with food. These focus groups were video recorded and professionally transcribed.
Public Agenda staff conducted four focus groups onsite at Children’s Aid in the Bronx, the Northern Manhattan Perinatal Partnership in Harlem, and Public Health Solutions in Queens, to which Public Agenda was connected by UHF. The community organizations recruited the participants, provided space and were compensated directly by UHF for doing so.
In total, 48 parents participated in the focus groups at the community organizations. All participants in these groups were parents of children ages five years and younger and clients of one or another of the community organizations and had experience taking their children to pediatricians. Three of the participants across the groups were fathers, and the rest were mothers. Grandparents were not included.
The focus groups lasted two hours. The participants were compensated for their time. Food and child care were provided, and some parents kept their children with them during the groups. The focus groups were audio recorded and professionally transcribed.
Of the four groups conducted at community organizations, two were conducted at Public Health Solutions in Spanish by Spanish-speaking Public Agenda staff. One was conducted in English at Children’s Aid and one at the Northern Manhattan Perinatal Partnership. Transcripts of the groups in Spanish were professionally translated into English.
More information about this study can be obtained at www.publicagenda.org/pages/
determinants-of-health or by emailing firstname.lastname@example.org.