I hadn't thought of some of these barriers - or to what extent they prevent parents from having a "primary" or "usual" source of medical care. The results were interesting. Summarized here:
Association Between Parental Barriers to Accessing a Usual Source of Care and Children’s Receipt of Preventive Services
Public Health Rep 2017 Mar 30;132(3):316–325. doi: 10.1177/0033354917699831
Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents’ reasons for not having a usual source of care were associated with their children’s receipt of preventive services.
Parents’ reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (
affordability), attitudes and beliefs about health care (
acceptability), and all other nonfinancial barriers (
accessibility, accommodation, and availability).
In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they “don’t need a doctor and/or haven’t had any problems” or they “don’t like, trust, or believe in doctors” had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children’s receipt of preventive services. Results were independent of several factors relevant to children’s access to preventive health care, including whether the child had a usual source of care.
The study concluded that:
Parents’ attitudes and beliefs about having a usual source of care were strongly associated with their children’s receipt of recommended preventive health services. Rates of receipt of child preventive services may be improved by addressing parents’ attitudes and beliefs about having a usual source of care.
The remaining unanswered question is how do we best try to address parents somewhat negative attitudes and beliefs about healthcare, and specifically having a usual source of care. I am concerned that may be a difficult task - changing someones beliefs, especially those that have been long held can certainly be difficult.
I'd love to hear any ideas on how to approach ANY such topic where a belief system may be incompatible with receiving quality health care.
Last year, while scheduling the CHW class sessions, I compiled this list.