Impact of an Approach to Integrated Care for Young Children in Low-Income Urban Settings: Perspectives of Primary Care Clinicians

Abstract

Objective: Parents and young children in low-income communities have compounding risk factors for their health and mental health, and integrated primary care has been identified as an effective approach for embedding needed auxiliary supports. Less is known about how primary care clinicians—who are key organizational drivers for integrated primary care—perceive the impact of this support on themselves and their clinics. Method: This study used a qualitative approach to gather clinicians’ perceptions of how HealthySteps (one approach to integrated care for young families) impacted their functioning and their clinic in an urban low-income community. Results: Thematic analysis of clinician interviews resulted in four themes. Clinicians opined that HealthySteps reduced their stress, eased their workload, and supported their job satisfaction in a setting where most families had significant psychosocial risk factors. They highlighted components of HealthySteps perceived to be the most impactful (e.g., tangible supports for families, connection to community services) and highlighted its role in improving relationships with families and case conceptualization. Conclusions: Recommendations are provided to leverage clinician voices to advocate for integrated primary care.

Implications for Impact Statement

Many young children and families present to primary care with complex psychosocial needs. Integrated primary care is an approach to addressing these needs by embedding psychosocial support staff into clinics to partner with primary care clinicians. In this qualitative study, clinicians described perceived impacts of implementing an integrated care model for young children, HealthySteps, into a low-income, urban clinic. Clinicians discussed the most impactful elements of HealthySteps implementation on clinician stress and clinic functioning.