WIP 84 - Family and stakeholder perceptions on community-embedded telehealth in mitigating access issues with developmental behavioral care

Publication Number: WIP 84.7399

Anna Le, Lucile Packard Children's Hospital Stanford, Sunnyvale, CA, United States; Annie Berens, Ayudando Latinos a Soñar (ALAS), Menlo Park, CA, United States; Christina Buysse, Stanford University, Half Moon Bay, CA, United States; Erendida E. Gonzalez, Stanford University School of Medicine, half moon bay, CA, United States

Background: Children from racially marginalized immigrant communities experience developmental behavioral (DB) challenges that are often exacerbated by stress and trauma embedded in social positionalities. Access to developmental-behavioral pediatric (DBP) care in these communities remains inadequate and inequitable. Billed a “double-edged sword,” however, telehealth can resolve some geographic access barriers while creating new equity issues related to factors like communication and technology access barriers. Research is needed to explore whether modifications to TH practices can reduce disparities.
Coastside PRIMES (Promoting Resilience at the Intersection of community, legal, Medical, and Educational Supports) is a community-embedded clinical pilot program that integrates DBP TH care with patient care navigation and legal advocacy to help address access issues faced by families in Half Moon Bay. In this novel project, a dedicated care coordinator supports families before, during, and after TH visits, which occur in the facilities of a trusted community organization that provides wrap-around services to a predominantly immigrant and farmworker community on California’s central coast.

Objective: This qualitative study explores perspectives of Latine patient families and community stakeholders, including perceived strengths and weaknesses, regarding using both standard DBP care approaches and the novel TH model.

Design/Methods: This qualitative study was approved by Stanford IRB. In-depth, semi-structured interviews about TH experiences were conducted with patient families, clinicians, allied health staff, and community stakeholders involved in the Coastside PRIMES model, and with patients seen in conventional in-person and TH DBP clinics. Stakeholder and patient family interviews were conducted in each participant’s preferred language, recorded and transcribed. Transcripts are now being inductively coded by a research team that reflects multiple positionalities relative to the subject matter. Thematic analysis of the data will be completed by 12/2024 and the manuscript by 3/2025.