P0040 - Civic Engagement: Family Perspectives on Health Policy and Voting Discussions Initiated by Primary Care Pediatricians

Background: In an election year with considerable consequences for child health policy, mobilizing patients and families as advocates for children is vital. Little is known, however, about whether and how to engage caregivers around health policy issues affecting families and children. Our cross-sectional, mixed-methods study aimed to assess caregiver interest, acceptance, and perspectives on health policy discussions within the pediatric primary care context.

Methods: Twenty-six semi-structured, in-depth interviews were conducted with a consecutive sample of caregivers in three, urban pediatric primary care clinics. Interviews were transcribed and structured questions were coded for dichotomous outcomes (e.g. “Yes or other affirmative answer” or “No or other negative answer”) by two coders with >90% inter-rater reliability. We assessed attitudes on pediatric office involvement regarding: current congressional debates on health insurance and other public programs affecting children; discussion of specific health policy topics; and voting. Not all participants opted to answer every question. We present here a summary of these quantitative data; a qualitative analysis of themes raised by participants is ongoing.

Results: The majority of participating caregivers identified as Black/African American (69%, 18/22) women (77%, 20/24). Fifty-eight percent (15/24) described themselves as currently insured through Medicare or Medicaid, and 81% (21/24) reported ever having received WIC and/or SNAP benefits. Forty-six percent (12/22) reported having at least one child with a chronic medical condition. Ninety-two percent (23/25) of respondents would want a pediatric provider to discuss upcoming Congressional votes on public insurance programs with them and 90% (19/21) would want to discuss any policy debate on programs affecting children. Seventy-eight percent (18/23) would want to discuss specific policy topics with their pediatrician (including education, disability rights, and vaccines among others). Just over half (13/25) felt that pediatricians should encourage caregivers and patients >18 years of age to vote. Use of printed materials and in-person conversation with a physician were the preferred method of communicating about health policy for 57% of participants.

Conclusion: In this small, consecutive sample, caregivers expressed a generally favorable view of pediatric primary care offices engaging them around relevant health policy issues but fewer were comfortable with offices encouraging eligible voters to vote in elections. Although preliminary, our findings suggest a role for pediatricians and pediatric outpatient clinics in urban centers in informing families about public policy debates with the potential to impact children. Future research should explore why certain provider discussions (e.g. voting) may be perceived as less acceptable.