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Abstract #148803

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Janet U. Schneiderman, PhD, RN¹, Dawn D. McDaniel, MA², and Bin Xie, PhD¹. (1) School of Social Work, University of Southern California, 669 West 34th Street, SWC 226, Los Angeles, CA 90089-0411, 213-821-1338, juschnei@usc.edu, (2) Department of Psychology, University of Southern California, 3620 McClintock Avenure, Los Angeles, CA 90089-1061

Primary caregivers (n=237) of children in the child welfare system were administered a modified Pediatric Access Survey (PAS) to identify barriers to accessing pediatric care. The participants interviewed were 28% birth parents (mean age: 33.7 years) in family maintenance, 25% related caregivers (mean age: 45.2 years) in foster care, and 46% unrelated caregivers (mean age: 46.6 years) in foster care. The results indicate that the access barriers most often identified was 1) difficulty understanding physicians and, in order of frequency, 2) wait too long to see a doctor, 3) clinic hours inconvenient and 4) too difficult to make an appointment. Birth parents were more likely to rate transportation as an access barrier (p=.00) and less likely to have used pediatric services (p=.05) than related or unrelated foster caregivers. Caregivers may have an unrealistic view of their child's health status since almost 87% rate their child's health as excellent or good when research has shown that these children have serious chronic health problems. These findings suggest that access barriers are not only a problem for foster parents, but important for birth parents of children in family maintenance, since birth parents identified similar access barriers but reported less usage of health services than foster parents. A majority of the participants (54%) felt that child welfare system fulfilled their responsibility in helping caregivers get the pediatric medical care needed although they felt caseworkers could assist more fully in transitions to new home placements (including securing Medicaid cards) and better referrals for specialty care.

Learning Objectives:

• List the access barriers identified by caregivers as affecting their ability to utilize pediatric care for children in the child welfare system.
• Differentiate the kind of access barrier identified by type of caregiver.
• Identify how social work caseworkers in the child welfare system can mitigate pediatric access barriers for caregivers.

Keywords: Access to Health Care, Child Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Audio (mp3) recording
• Slides (pdf) or Handout