Explaining culturally and linguistically diverse (CALD) parents\u2019 access of healthcare services for developmental surveillance and anticipatory guidance: qualitative findings from the \u2018Watch Me Grow\u2019 study

Pankaj Garg,Anne Mckenzie,John Eastwood,Kate Short,Bin Jalaludin,Natalie Silove,Stewart Einfeld,Susan Harvey,Sue Woolfenden,Elisabeth Murphy,Cheryl Dissanayake,Katrina Williams,Valsamma Eapen,My Trinh Ha

doi:10.1186/s12913-017-2143-1

Abstract

BackgroundRegular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. However, there are few published reports from Australian culturally and linguistically diverse (CALD) communities exploring parents’ experiences for accessing child health surveillance programs. This paper aims to describe and explain parental experiences for accessing developmental surveillance and anticipatory guidance for children.MethodsQualitative data was obtained from 6 focus groups (33 parents) and seven in-depth interviews of CALD parents recruited from an area of relative disadvantage in Sydney. Thematic analysis of data was conducted using an ecological framework.ResultsAn overarching theme of “awareness-beliefs-choices” was found to explain parents’ experiences of accessing primary health care services for children. “Awareness” situated within the meso-and macro-systems explained parents knowledge of where and what primary health services were available to access for their children. Opportunities for families to obtain this information existed at the time of birth in Australian hospitals, but for newly arrived immigrants with young children, community linkages with family and friends, and general practitioner (GPs) were most important. “Beliefs” situated within the microsystems included parents’ understanding of their children’s development, in particular what they considered to be “normal” or “abnormal”. Parental “choices”, situated within meso-systems and chronosystems, related to their choices of service providers, which were based on the proximity, continuity, purpose of visit, language spoken by the provider and past experience of a service.ConclusionsCALD parents have diverse experiences with primary health care providers which are influenced by their awareness of available services in the context of their duration of stay in Australia. The role of the general practitioner, with language concordance, suggests the importance of diversity within the primary care health workforce in this region. There is a need for ongoing cultural competence training of health professionals and provisions need to be made to support frequent use of interpreters at general practices in Australia.

Highlights

Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry
culturally and linguistically diverse (CALD) parents have diverse experiences with primary health care providers which are influenced by their awareness of available services in the context of their duration of stay in Australia
A preventative approach through anticipatory guidance is commonly incorporated into child health checks, which refer to informing parents of what to expect at the stage of their child’s development and providing them information on issues such as nutrition, sleep and settling, behaviour management and injury prevention

Summary

Introduction

Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. A preventative approach through anticipatory guidance is commonly incorporated into child health checks, which refer to informing parents of what to expect at the stage of their child’s development and providing them information on issues such as nutrition, sleep and settling, behaviour management and injury prevention. This information is often provided in conjunction with regular health checks, developmental surveillance and child and family psychosocial assessment [4, 5]. There is limited uptake of developmental screening and surveillance, and the uptake is reduced further where children come from a culturally and linguistically diverse (CALD) backgrounds [8]

Objectives

Methods

Results

Discussion

Conclusion