Understanding barriers to well-child visit attendance among racial and ethnic minority parents

BMC Prim Care. 2024 Jun 3;25(1):196. doi: 10.1186/s12875-024-02442-0.

Abstract

Objectives: To assess racial and ethnic minority parents' perceptions about barriers to well-child visit attendance.

Methods: For this cross-sectional qualitative study, we recruited parents of pediatric primary care patients who were overdue for a well-child visit from the largest safety net healthcare organization in central Massachusetts to participate in semi-structured interviews. The interviews focused on understanding potential knowledge, structural, and experiential barriers for well-child visit attendance. Interview content was inductively coded and directed content analysis was performed to identify themes.

Results: Twenty-five racial and ethnic minority parents participated; 17 (68%) of whom identified Spanish as a primary language spoken at home. Nearly all participants identified the purpose, significance, and value of well-child visits. Structural barriers were most cited as challenges to attending well-child visits, including parking, transportation, language, appointment availability, and work/other competing priorities. While language emerged as a distinct barrier, it also exacerbated some of the structural barriers identified. Experiential barriers were cited less commonly than structural barriers and included interactions with office staff, racial/ethnic discrimination, appointment reminders, methods of communication, wait time, and interactions with providers.

Conclusions: Racial and ethnic minority parents recognize the value of well-child visits; however, they commonly encounter structural barriers that limit access to care. Furthermore, a non-English primary language compounds the impact of these structural barriers. Understanding these barriers is important to inform health system policies to enhance access and delivery of pediatric care with a lens toward reducing racial and ethnic-based inequities.

Keywords: Barriers to care; Health inequity; Language; Well-child visits.

MeSH terms

  • Adult
  • Child
  • Child Health Services
  • Child, Preschool
  • Communication Barriers
  • Cross-Sectional Studies
  • Ethnic and Racial Minorities*
  • Ethnicity / psychology
  • Female
  • Health Services Accessibility
  • Humans
  • Interviews as Topic
  • Male
  • Massachusetts
  • Middle Aged
  • Parents* / psychology
  • Qualitative Research*