A Qualitative Study of Caregiver Perspectives on Health Policy Discussions Initiated by Pediatricians.

BACKGROUND AND OBJECTIVE: Prior studies suggest that pediatricians believe discussing health policy issues with families is important. Caregiver preferences on these discussions, however, have not been examined. We explored circumstances in which caregivers may be receptive to discussing health policy issues with pediatricians. METHODS: We conducted 26 semistructured interviews with mostly Black female caregivers at 3 urban academic pediatric primary care practices. Using both structured and open response questions, we explored 4 primary content areas: 1) caregivers' perspectives on discussing health policy issues in pediatricians' offices; 2) which health policy topics caregivers may prefer to discuss; 3) factors that render policy discussions in the clinic inappropriate to caregivers; and 4) which communication modalities caregivers prefer. Interview transcripts were coded and analyzed using content analysis. RESULTS: Themes that emerged from interviews included: 1) pediatricians are perceived as trusted information sources on health policy; 2) caregivers want to talk with pediatricians about children's health insurance policy changes; 3) time constraints are a barrier to health policy discussions; 4) caregivers prefer to discuss health policy topics during well-child visits; 5) caregivers want the option to opt-out of these conversations; 6) preferred modalities for communicating about health policy issues, including printed materials and health fairs or educational events. CONCLUSIONS: Caregivers expressed a satisfactory view of pediatricians discussing directly relevant health policy issues, including congressional debates on health insurance, in the primary care setting. Our findings highlight other caregiver preferences for engaging families in health policy discussions, including the timing of these conversations.

Effectiveness of Deworming with Single-Dose Albendazole for Preschool-Aged Children in the Dominican Republic.

Background. The World Health Organization recommends biannual deworming with single-dose albendazole for all children over 1 year in regions where soil-transmitted helminths (STH) are endemic. There are limited data from the Dominican Republic (DR) on the effectiveness of deworming programs. Methods. Between January and June 2019, we enrolled 63 preschool-aged children at a community clinic in the DR. Participants received albendazole at enrollment. Stool samples were collected and examined for parasites at enrollment, 2 to 4 and 12 to 16 weeks post-albendazole. Caregivers were surveyed on home hygiene practices and children's symptoms. Findings. At enrollment, 1 or more parasites were noted in 89% of samples. Ascaris lumbricoides (68%) was the most common species, followed by Entamoeba histolytica (35%) and Giardia intestinalis (8%). Two-to-four weeks post-albendazole, fewer than half of those with A. lumbricoides infections at baseline had cleared the infection. STH symptoms significantly improved between enrollment and 2 to 4 weeks. By 12 to 16 weeks after treatment, A. lumbricoides infections were as high as baseline. Interpretation. Although limited by size and available technology, our study contributes data on STH in the DR. Single-dose deworming with albendazole did not reduce Ascaris lumbricoides infections in our sample. As STH are the most common neglected tropical diseases and negatively impact children's health globally, further studies on both effective deworming programs and interventions to prevent STH are needed.