Abstract
Objective
To understand US parent health care-seeking decisions in the context of multiple in-person
and telehealth care options. As the health care landscape evolves, new research is
needed to explain how parents now decide when and where to seek acute pediatric health
care.
Methods
We applied a mental models approach, focusing on the archetypal example of care-seeking
for pediatric acute respiratory tract infections (ARTIs), by first reviewing pediatric
ARTI guidelines with 16 health care professionals to inform 40 subsequent semi-structured
interviews with parents of young children in 2021. Interviews were qualitatively coded
using thematic analysis, with code frequency and co-occurrence informing the final
influence model of parent health care-seeking decisions.
Results
Parent interviewees identified 33 decisional factors which were synthesized into seven
dimensions influencing care-seeking decisions: perceived illness severity, perceived
child susceptibility, parental self-efficacy, expected accessibility of care, expected
affordability of care, expected quality of clinician, and expected quality of site.
The first three dimensions (perceived severity, perceived susceptibility, parental
self-efficacy) influenced an initial decision about whether to seek care, while all
seven factors influenced a subsequent decision about where to seek care (e.g., in-person
primary care, primary care-based telehealth, urgent care, direct-to-consumer telehealth).
Uncertainty was present within many dimensions (e.g., severity, access, quality) indicating
potential targets to support parent decision making processes and optimize care-seeking
behaviors.
Conclusion
A mental models approach identified dimensions influencing parent choice to seek care
and choice of care site for children with ARTIs, suggesting targets to advance family-centered
practice and policy.
Abbreviations:
ARTI (acute respiratory tract infection), DTC (direct-to-consumer), ED (emergency department), CHIP (Children’s Health Insurance Plan), PCP (primary care provider), US (United States)Keywords
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Article info
Publication history
Accepted:
February 24,
2023
Received:
October 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
All rights reserved.
