title: Factors That Matter to Low-Income and Racial/Ethnic Minority Mothers When Choosing a Pediatric Practice: a Mixed Methods Analysis.
abstract: BACKGROUND
  Pediatric practices' scores on healthcare quality measures are increasingly available to the public. However, patients from low-income and racial/ethnic minority populations rarely use these data. We sought to understand potential barriers to using quality data by assessing what factors mattered to women when choosing a pediatric practice.
  
  
  METHODS
  As part of a randomized trial to overcome barriers to using quality data, we recruited women from a prenatal clinic serving an underserved population. Women reported how much 12 factors mattered when they chose a pediatric practice (5-point Likert scale), what other factors mattered to them, and which factors mattered the most. We assessed whether factor importance varied with selected participant characteristics and qualitatively analyzed the "other" factors named.
  
  
  RESULTS
  Participants' (n = 367) median age was 23 years, and they were largely Hispanic (60.4%), white (21.2%), or black (16.9%). Insurance acceptance "mattered a lot" to the highest percentage of women (93.2%), while online information about what other parents think of a practice "mattered a lot" to the fewest (7.4%). Major themes from our qualitative analysis of "other" factors that mattered included physicians' interpersonal skills and pediatrician-specific traits. Factors related to access "mattered the most" to the majority of women.
  
  
  CONCLUSIONS
  Pediatrician characteristics and factors related to access to care may be more important to low-income and racial/ethnic minority women than more commonly reported quality metrics. Aligning both the content and delivery of publicly reported quality data with women's interests may increase use of pediatric quality data.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01784575.
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA. sarah.goffmd@baystatehealth.org.|Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA. sarah.goffmd@baystatehealth.org.|Department of Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111,, USA. sarah.goffmd@baystatehealth.org.|, 280 Chestnut St., Room 305, Springfield, MA, 01104,, USA. sarah.goffmd@baystatehealth.org.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Goff
authors.affiliation: University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655,, USA.|Meyers Primary Care Institute, University of Massachusetts Medical School, 425 North Lake Avenue, Worcester, MA, 01605,, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Mazor
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.
authors.forename: Haley
authors.initials: H
authors.lastname: Guhn-Knight
authors.affiliation: Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114,, USA.
authors.forename: Yara Youssef
authors.initials: YY
authors.lastname: Budway
authors.affiliation: Renal and Transplant Associates of New England, 100 Wason Ave # 200, Springfield, MA, 01107,, USA.
authors.forename: Lorna
authors.initials: L
authors.lastname: Murphy
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center, 720 Harrison Ave, Boston, MA, 02118,, USA.|University of Massachusetts School of Public Health and Health Sciences, Amherst, MA, 01003,, USA.
authors.forename: Katharine O
authors.initials: KO
authors.lastname: White
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|Department of Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111,, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Lagu
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|University of Massachusetts School of Public Health and Health Sciences, Amherst, MA, 01003,, USA.
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Pekow
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.
authors.forename: Aruna
authors.initials: A
authors.lastname: Priya
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199,, USA.|Department of Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111,, USA.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D002755:Choice Behavior; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007341:Insurance / Q000706:statistics & numerical data; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010372:Pediatrics; D011203:Poverty; D011247:Pregnancy; D011787:Quality of Health Care; D044469:Racial Groups / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Choosing a pediatric practice; Low income; Minority; Pediatric healthcare quality; Pregnant women