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Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study

Author

Listed:
  • Bria Hall
  • Allison Tegge
  • Cesia Cotache Condor
  • Marie Rhoads
  • Terri-Ann Wattsman
  • Angelica Witcher
  • Elizabeth Creamer
  • Anna Tupetz
  • Emily R Smith
  • Mamata Reddy Tokala
  • Brian Meier
  • Henry E Rice

Abstract

Background: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-making when accessing surgical care for children, to confirm if family experiences impact delays in care, and to describe differences in family experiences across populations (race, ethnicity, socioeconomic status, rurality). Methods: We will use a prospective, cross-sectional, mixed methods design to examine family experiences during access to care for children with appendicitis. Participants will include 242 parents of consecutive children (0–17 years) with acute appendicitis over a 15-month period at two academic health systems in North Carolina and Virginia. We will collect demographic and clinical data. Parents will be administered the Adult Responses to Children’s Symptoms survey (ARCS), the child and parental forms of the Adverse Childhood Experiences (ACE) survey, the Accountable Health Communities Health-Related Social Needs Screening Tool, and Single Item Literacy Screener. Parallel ARCS data will be collected from child participants (8–17 years). We will use nested concurrent, purposive sampling to select a subset of families for semi-structured interviews. Qualitative data will be analyzed using thematic analysis and integrated with quantitative data to identify emerging themes that inform a conceptual model of family-level decision-making during access to surgical care. Multivariate linear regression will be used to determine association between the appendicitis perforation rate and ARCS responses (primary outcome). Secondary outcomes include comparison of health literacy, ACEs, and SDOH, clinical outcomes, and family experiences across populations. Discussion: We expect to identify key family experiences when accessing care for appendicitis which may impact outcomes and differ across populations. Increased understanding of how SDOH and family experiences influence family decision-making may inform novel strategies to mitigate surgical disparities in children.

Suggested Citation

  • Bria Hall & Allison Tegge & Cesia Cotache Condor & Marie Rhoads & Terri-Ann Wattsman & Angelica Witcher & Elizabeth Creamer & Anna Tupetz & Emily R Smith & Mamata Reddy Tokala & Brian Meier & Henry E , 2024. "Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study," PLOS ONE, Public Library of Science, vol. 19(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0304165
    DOI: 10.1371/journal.pone.0304165
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    References listed on IDEAS

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    1. Ellen A. Lipstein & William B. Brinkman & Maria T. Britto, 2012. "What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making," Medical Decision Making, , vol. 32(2), pages 246-258, March.
    2. Gabe, Jonathan & Olumide, Gillian & Bury, Michael, 2004. "'It takes three to tango':: a framework for understanding patient partnership in paediatric clinics," Social Science & Medicine, Elsevier, vol. 59(5), pages 1071-1079, September.
    3. Greg Guest & Emily Namey & Mario Chen, 2020. "A simple method to assess and report thematic saturation in qualitative research," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-17, May.
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