Addressing Psychosocial Topics in Group Well-Child Care: A Multi-Method Study With Immigrant Latino Families

Abstract

Objective: Group Well-Child Care (GWCC) has been described as providing an opportunity to enhance well-being for vulnerable families experiencing psychosocial challenges. We sought to explore benefits and challenges to the identification and management of psychosocial concerns in Group Well-Child Care (GWCC) with immigrant Latino families.

Methods: We conducted a case study of GWCC at an urban academic general pediatric clinic serving predominantly Limited English Proficiency Latino families, combining visit observations, interviews, and surveys with Spanish-speaking mothers participating in GWCC, and interviews with providers delivering GWCC. We used an adapted framework approach to qualitative data analysis.

Results: A total of 42 mothers and 9 providers participated in the study; a purposefully selected subset of 17 mothers was interviewed, all providers were interviewed. Mothers and providers identified both benefits and drawbacks to the structure and care processes in GWCC. The longer total visit time facilitated screening and education around psychosocial topics such as postpartum depression but made participation challenging for some families. Providers expressed concerns about the effects of shorter one-on-one time on rapport-building; most mothers did not express similar concerns. Mothers valued the opportunity to make social connections and to learn from the lived experiences of their peers. Discussions about psychosocial topics were seen as valuable but required careful navigation in the group setting, especially when fathers were present.

Conclusions: Participants identified unique benefits and barriers to addressing psychosocial topics in GWCC. Future research should explore the effects of GWCC on psychosocial disclosures and examine ways to enhance benefits while addressing the challenges identified.

Keywords: Latino; group well-child care; psychosocial information.

Figure 1:. Study and Visit Procedures

*For visit screening, clinic used the Spanish version of the Survey of Well-Being of Young Childhood (SWYC; © Tufts Medical Center 2010; Available at https://www.tuftschildrenshospital.org/the-survey-of-wellbeing-of-young-children/overview). It includes questions about developmental and behavioral milestones, maternal mood, and family context.