title: The voices of limited English proficiency Latina mothers on pediatric primary care: lessons for the medical home.
abstract: The objective of this study is to inform medical home implementation in practices serving limited English proficiency Latino families by exploring limited English proficiency Latina mothers' experiences with, and expectations for, pediatric primary care. In partnership with a federally-qualified community health center in an urban Latino neighborhood, we conducted semi-structured interviews with 38 low-income Latina mothers. Eligible participants identified a pediatric primary care provider for their child and had at least one child 3 years old or younger, to increase the probability of frequent recent interactions with health care providers. Interview transcripts were coded and analyzed through an iterative and collaborative process to identify participants' satisfaction with and expectations for pediatric primary care. About half of the mothers interviewed were satisfied with their primary care experiences. Mothers suggested many ways to improve the quality of pediatric primary care for their children to better meet the needs of their families. These included: encouraging providers to invest more in their relationship with families, providing reliable same-day sick care, expanding hours, improving access to language services, and improving care coordination services. Limited English proficiency Latina mothers expect high-quality pediatric primary care consistent with the medical home model. Current efforts to improve primary care quality through application of the medical home model are thus relevant to this population, but should focus on the parent-provider relationship and timely access to care. Promoting this model among practices that serve limited English proficiency Latino families could improve engagement and satisfaction with primary care.
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Center for Child and Community Health Research, 5200 Eastern Ave, Baltimore, MD 21224, USA. ldecamp1@jhmi.edu
authors.forename: Lisa Ross
authors.initials: LR
authors.lastname: DeCamp
authors.forename: Edith
authors.initials: E
authors.lastname: Kieffer
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Zickafoose
authors.forename: Sonya
authors.initials: S
authors.lastname: DeMonner
authors.forename: Felix
authors.initials: F
authors.lastname: Valbuena
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003144:Communication Barriers; D055812:Community-Based Participatory Research; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008297:Male; D009035:Mothers; D018802:Patient-Centered Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D010372:Pediatrics; D011320:Primary Health Care / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D036301:Qualitative Research; D012959:Socioeconomic Factors; D014505:Urban Population