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



Qualitative 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.



An 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.



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. 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.
Department of Community Paediatrics, Liverpool Hospital, Liverpool, Australia.|School of Women's and Children's Health, UNSW, Liverpool, Australia.|School of Medicine, University of Sydney, Westmead, Australia.|Ingham Institute of Applied Medicine, Liverpool, Australia.
Pankaj
P
Garg
University of Western Sydney, Penrith, NSW, Australia.
My Trinh
MT
Ha
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.|School of Public Health, University of Sydney, Sydney, NSW, Australia.|Ingham Institute of Applied Medicine, Liverpool, Australia.|School of Medicine, Griffith University, Gold Coast, QLD, Australia.|Syney Local Health District, Croydon, NSW, Australia.
John
J
Eastwood
School of Nursing and Midwifery, Griffiths University, Queensland, Australia.
Susan
S
Harvey
Sydney Children's Hospital Network (Randwick), UNSW, Sydney, Australia.
Sue
S
Woolfenden
NSW Ministry of Health, Sydney, Australia.
Elisabeth
E
Murphy
Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia.
Cheryl
C
Dissanayake
South Western Sydney Local Health District and UNSW, Sydney, Australia.
Bin
B
Jalaludin
Royal Children's Hospital, Melbourne and University of Melbourne, Murdoch Childrens Research Institute, Melbourne, Australia.
Katrina
K
Williams
Primary and Community Health, Child, Youth and Family, Child and Family Health Nursing, South Western Sydney Local Health District, Sydney, Australia.
Anne
A
McKenzie
Centre for Disability Research and Policy and Brain and Mind Centre, University of Sydney, Sydney, Australia.
Stewart
S
Einfeld
The Children's Hospital at Westmead, University of Sydney, Sydney, Australia.
Natalie
N
Silove
Liverpool Hospital, South Western Sydney LHD, University of Sydney, Sydney, Australia.
Kate
K
Short
UNSW, South Western Sydney LHD, Ingham Institute of Applied Medicine, Liverpool, Australia. v.eapen@unsw.edu.au.|Infant Child and Adolescent Psychiatry, Academic Unit of Child Psychiatry, South West Sydney LHD, ICAMHS, Mental Health Centre, University of New South Wales, Liverpool Hospital, L1, Elizabeth Street, Liverpool, NSW, 2170, Sydney, Australia. v.eapen@unsw.edu.au.
Valsamma
0000-0001-6296-8306
V
Eapen
D002648:Child; D002657:Child Development; D002662:Child Health Services / Q000592:standards*; D003153:Community Health Services / Q000458:organization & administration; D054521:Cultural Competency; D018864:Cultural Diversity; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007802:Language; D009517:New South Wales; D010290:Parents; D011320:Primary Health Care / Q000458:organization & administration; D012959:Socioeconomic Factors
Access; Child development; Culturally and linguistically diverse; Ecological framework; Health services