Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspect
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Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives Shanna Doucette Knierim1,2 · Susan L. Moore3,4 · Silvia Gutiérrez Raghunath3 · Lourdes Yun5 · Richard E. Boles2 · Arthur J. Davidson5
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/ or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator’s role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore. Keywords Home visit · Patient navigators · Parent perspectives · Focus groups · Pediatric obesity · Latino
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-018-2553-7) contains supplementary material, which is available to authorized users. * Shanna Doucette Knierim [email protected]
1
Ambulatory Care Services, Denver Health, 601 Broadway Street, Mail Code 1914, Denver, CO 80203, USA
Susan L. Moore [email protected]
2
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
Silvia Gutiérrez Raghunath [email protected]
3
Center for Health Systems Research, Denver Health, Denver, CO, USA
Lourdes Yun [email protected]
4
Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
Richard E. Boles Richard.Boles@
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