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

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dc.contributor.authorHall, Briaen
dc.contributor.authorTegge, Allisonen
dc.contributor.authorCondor, Cesia Cotacheen
dc.contributor.authorRhoads, Marieen
dc.contributor.authorWattsman, Terri-Annen
dc.contributor.authorWitcher, Angelicaen
dc.contributor.authorCreamer, Elizabethen
dc.contributor.authorTupetz, Annaen
dc.contributor.authorSmith, Emily R.en
dc.contributor.authorTokala, Mamata Reddyen
dc.contributor.authorMeier, Brianen
dc.contributor.authorRice, Henry E.en
dc.date.accessioned2024-08-23T13:47:46Zen
dc.date.available2024-08-23T13:47:46Zen
dc.date.issued2024-06-24en
dc.description.abstractBackground 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.en
dc.description.versionPublished versionen
dc.format.extent15 page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifierARTN e0304165 (Article number)en
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0304165en
dc.identifier.eissn1932-6203en
dc.identifier.issn1932-6203en
dc.identifier.issue6en
dc.identifier.orcidWattsman, Terri-ann [0000-0003-3976-4684]en
dc.identifier.otherPONE-D-23-24866 (PII)en
dc.identifier.pmid38913675en
dc.identifier.urihttps://hdl.handle.net/10919/120996en
dc.identifier.volume19en
dc.language.isoenen
dc.publisherPLoSen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/38913675en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectSocial Determinants of Healthen
dc.subjectHealth Disparitiesen
dc.subjectProtocolen
dc.subjectMixed methodsen
dc.subjectParentsen
dc.subjectChildrenen
dc.subjectSurgical careen
dc.subject.meshHumansen
dc.subject.meshAppendicitisen
dc.subject.meshProspective Studiesen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshFamilyen
dc.subject.meshParentsen
dc.subject.meshDecision Makingen
dc.subject.meshAdolescenten
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshHealth Services Accessibilityen
dc.subject.meshNorth Carolinaen
dc.subject.meshVirginiaen
dc.subject.meshFemaleen
dc.subject.meshMaleen
dc.titleUnderstanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods studyen
dc.title.serialPLOS ONEen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dc.type.otherJournalen
dcterms.dateAccepted2024-05-03en
pubs.organisational-groupVirginia Techen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Surgeryen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Emergency Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Emergency Medicine/Emergency Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Surgery/Neurosurgeryen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/TEACH Membersen

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