Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Marjorie S. Rosenthal

Subject Area(s)

Health education, Public health, Medicine

Abstract

Family child care providers, who are trusted by parents and disproportionately serve families in poverty, may be in an ideal position to provide health education for vulnerable families. Prior research found that family child care providers perceive that they act as health educators and advisors for families. The perception of this role by others who are also invested in a family's health remains unclear. We hypothesized that parents receive health information from a myriad of sources but that their relationship to their children's family child care providers elevates the importance, relevance, and desire to adhere to the health information parents receive from child care providers. Further we anticipated that health care providers and community service providers do not currently utilize child care providers to disseminate health information nor to serve as a conduit for health care access but they perceive a collaboration between the two may be feasible. This thesis aims to characterize how parents, health care providers, and community service providers experience and perceive this role in order to assess and develop future trainings and support services promoting children's health. Methods: We conducted in-depth interviews with a purposeful sample of parents whose children attend family child care homes (n=11), health care providers (n=12) and community service providers (n=25) in New Haven, CT using a standardized interview guide. Interviews were audiotaped, transcribed, and synthesized into common themes using the constant comparative method of qualitative data analysis. Results: Six unifying themes characterize the experiences and perceptions of the interviewees regarding the child care providers as community health workers: 1) Families struggle to meet basic needs, 2) Comprehensive health care is important but uncompensated, 3) Family child care providers have experience, but not expertise, 4) Good communication is critical in building trust and discussing concerns with parents, 5) Personal relationships enable collaboration and trust, and 6) The scope of advice to parents should be limited to agreed upon topics in order for family child care providers to obtain best practice. Conclusion: Trusting, longitudinal relationships with frequent interactions between parents and family child care providers may make child care providers ideal conduits for health education of vulnerable families. A public health system of health education for parents should incorporate child care providers as community health workers.

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