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

• DOI: 10.1186/s12913-017-2143-1
• Publication Date: 2017-03-22T05:04:44Z
• Authors: Pankaj Garg; My Trinh Ha; John Eastwood; Susan Harvey; Sue Woolfenden; Elisabeth Murphy; Cheryl Dissanayake; Bin Jalaludin; Katrina Williams; Anne McKenzie; Stewart Einfeld; Natalie Silove; Kate Short; Valsamma Eapen
• Keywords: Parents; Sydney (N.S.W.); anzsrc-for: 4205 Nursing; Child Health Services; 8.1 Organisation and delivery of services; anzsrc-for: 0807 Library and Information Studies; Health Services Accessibility; Child Development; 0302 clinical medicine; 7.1 Individual care needs; Community Health Services; Cultural Competency; Child; Language; Pediatric; 360; Public health; anzsrc-for: 42 Health Sciences; Ecological framework; Health Policy; 4. Education; 3 Good Health and Well Being; Cultural Diversity; Health Services; families; Focus Groups; 4203 Health Services and Systems; Access; 3. Good health; anzsrc-for: 4203 Health Services and Systems; Culturally and linguistically diverse; Female; New South Wales; cultural competence; anzsrc-for: 1117 Public Health and Health Services; Research Article; Health Personnel; anzsrc-for: 1110 Nursing; anzsrc-for: 4206 Public health; Emigrants and Immigrants; Nursing; Basic Behavioral and Social Science; 03 medical and health sciences; children; Clinical Research; Behavioral and Social Science; XXXXXX - Unknown; Health services and systems; Humans; child development; Primary Health Care; 42 Health Sciences; 300; primary health care; Socioeconomic Factors

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.