A Qualitative Study of Caregiver Perspectives on Health Policy Discussions Initiated by Pediatricians

Prior studies suggest that pediatricians believe discussing health policy issues with families is important. Caregiver preferences on these discussions, however, have not been examined. We explored circumstances in which caregivers may be receptive to discussing health policy issues with pediatricians. We conducted 26 semistructured interviews with mostly Black female caregivers at 3 urban academic pediatric primary care practices. Using both structured and open response questions, we explored 4 primary content areas: 1) caregivers’ perspectives on discussing health policy issues in pediatricians' offices; 2) which health policy topics caregivers may prefer to discuss; 3) factors that render policy discussions in the clinic inappropriate to caregivers; and 4) which communication modalities caregivers prefer. Interview transcripts were coded and analyzed using content analysis. Themes that emerged from interviews included: 1) pediatricians are perceived as trusted information sources on health policy; 2) caregivers want to talk with pediatricians about children's health insurance policy changes; 3) time constraints are a barrier to health policy discussions; 4) caregivers prefer to discuss health policy topics during well-child visits; 5) caregivers want the option to opt-out of these conversations; 6) preferred modalities for communicating about health policy issues, including printed materials and health fairs or educational events. Caregivers expressed a satisfactory view of pediatricians discussing directly relevant health policy issues, including congressional debates on health insurance, in the primary care setting. Our findings highlight other caregiver preferences for engaging families in health policy discussions, including the timing of these conversations.