The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families

BMC Pediatrics

Christine Loock¹  Lorine Scott³  Koushambhi B Khan²  M Judith Lynam²  Sabrina T Wong⁴ 

[1] Department of Paediatrics, UBC Faculty of Medicine, 4480 Oak Street, Vancouver, V6H 3V4, BC, Canada;University of British Columbia, School of Nursing and Research, 6190 Agronomy Road, #302, Vancouver, V6T 1Z3, BC, Canada;Children’s Hospital, K1-111, 4480 Oak Street, Vancouver, V6H 3V4, BC, Canada;University of British Columbia, Centre for Health Services Policy, #201-2206 East Mall, Vancouver, V6T-1Z3, BC, Canada

关键词: Community engagement;    Empowerment;    Innovative model;    Vulnerable populations;    Public health;    Primary care;   

Others  :  1170639
DOI  :  10.1186/1471-2431-12-158

 received in 2011-04-28, accepted in 2012-09-26,  发布年份 2012

【 摘 要 】

Background

The Responsive Interdisciplinary Child-Community Health Education and Research (RICHER) initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC) model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for ‘at risk’ children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1) access to health care for children and families with multiple forms of disadvantage and 2) patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach.

Methods

This was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86) and thematic analyses of patient interview data (n=7) were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment.

Results

Respondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider’s interpersonal style (e.g., being treated as an equal), was very important. Even after controlling for parents’ education and ethnicity, the provider’s interpersonal style remained positively associated with parent-reported empowerment (p<0.01).

Conclusions

This model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can better meet the health and health care needs of people, especially those who are vulnerable due to multiple intersecting social determinants of health. Positive interpersonal communication from providers can play a key role in facilitating situations where individuals have an opportunity to experience success in managing their and their family’s health.

【 授权许可】

   
2012 Wong et al.; licensee BioMed Central Ltd.

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