Hospitalized Children
Conditions
Brief summary
The overall goal of this research is to evaluate a new program designed to address basic human needs, create a safe and supportive environment for families, and help families build skills and confidence for navigating the health care system. Specifically, we aim to pilot test the feasibility and acceptability of the Targeted Inpatient Navigation (TNav) program for families of low income, minority hospitalized children.
Interventions
BEHAVIORALFamily Bridge Program
Families receive Family Bridge Program services which include orientation to the hospital, concrete needs assessment, communication preferences assessment, communication coaching, follow-up during the hospital stay, and a follow-up phone call after discharge.
Sponsors
Seattle Children's Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Caregiver ≥18 years of age, with a hospitalized child \<18 years old * Preferred language of English, Spanish and Somali * child with Medicaid insurance or no insurance * child with self-reported (or parent-reported) minority race/ethnicity * within 3 days of admission/ transfer to the medical unit on a general medicine service of a resident team
Exclusion criteria
* Admission for suspected child abuse * Involvement of Child Protective Services at time of admission * Admission for primary mental health condition, including intentional ingestion and eating disorder * Family already enrolled in longer-term navigation services
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Program acceptability to caregivers--qualitative | 4-6 weeks after discharge | Program acceptability will be determined qualitatively, on the basis of thematic content analysis of semi-structured interviews with enrolled caregivers |
| Program feasibility | Calculated for each family after program involvement is complete, generally 1 week after discharge. | Ability to deliver program elements as planned, calculated as the number of Family Bridge services delivered to a family divided by the services available to that family. |
| Program acceptability to providers--qualitative | Once per month, every month that they care for an enrolled family, up to 6 months | Program acceptability will be determined qualitatively, on the basis of thematic content analysis of semi-structured interviews with the doctors, nurses, social workers and care coordinators who were involved in their hospital care. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceived Stress Scale-short form | Enrollment and 2-4 weeks after discharge. | 4 items, scored from 0 (Never) to 4 (Very Often), related to perceived stress and control over one's life. Responses are summed for a total score from 0 to 16, with higher scores reflecting greater stress. |
| Local system navigation | Enrollment and 2-4 weeks after discharge. | 9 items assessing familiarity with navigating the local health care system. |
| Communication--Pediatric H-CAHPS | 2-4 weeks after discharge. | 9 items assessing quality of communication from doctors and nurses, including at discharge. |
| Cultural Distance Scale | Enrollment and 2-4 weeks after discharge. | 4 items measuring perceived similarity or difference in norms and values between family and medical providers. Each of the 4 items is scored on a Likert scale from 1 to 6, with higher values reflecting greater difference. The total scale score is the average of the 4 responses, on a scale from 1 to 6. |
| Health care transition questions | 2-4 weeks after discharge. | 10 items assessing quality of transition and comfort and understanding of home care. |
| Unmet need for navigation | 2-4 weeks after discharge. | 7 items to determine whether family's needs were identified and met during hospitalization |
| Partnership--Pediatric H-CAHPS | 2-4 weeks after discharge. | 3 items assessing provider-family partnership. |
| Barriers to Care Questionnaire | Enrollment and 2-4 weeks after discharge. | 20 items measuring perceived barriers to medical care, with 4 sub-scales, each scored and reported separately: System as a whole, Skills barriers, Expectation barriers, and Knowledge barriers. Each subscale was scored 0-100, with higher scores indicating greater barriers. |
| Perceived Efficacy in Patient-Physician Interactions (PEPPI) | Enrollment and 2-4 weeks after discharge. | 10-item tool measuring understanding of and ability to interact with health professionals and organizations. |
Countries
United States
Outcome results
None listed