Pediatric Residents' Perspective on Family-Clinician Discordance in Primary Care: A Qualitative Study

J Health Care Poor Underserved. 2016;27(3):1033-45. doi: 10.1353/hpu.2016.0114.

Abstract

The engagement of families in health maintenance is associated with better child health outcomes, but demographic discordance between families and clinicians may be a barrier to family engagement. Using a longitudinal qualitative study design, we conducted 15 semi-structured interviews with five pediatric residents who elected to facilitate group well child care (GWCC). Four themes describing residents' perceptions of the role of discordance in family-clinician engagement include: 1) discordance was not a barrier; 2) discordance leads to a lack of engagement and trust; 3) residents transcended discordance in GWCC because either GWCC led residents to change their communication techniques or because, with GWCC, parents have concordant adults in the room; and 4) the education residents obtained in GWCC allowed them to empathize with the families' health-related decisions. Finding ways in which pediatric providers can improve skills in family engagement may be an important step in decreasing health inequities.

MeSH terms

  • Child
  • Family Health
  • Humans
  • Internship and Residency*
  • Parents
  • Pediatric Assistants*
  • Physicians
  • Primary Health Care*
  • Qualitative Research*