Head Start's Role in Addressing Food and Nutrition Insecurity: Focus Group Findings.

OBJECTIVE: To elicit Head Start (HS) families' and employees' perspectives on family experiences with food and nutrition insecurity (FNI) and identify how HS addresses them. METHODS: Four moderated virtual focus groups with 27 HS employee and family participants occurred from August 2021 to January 2022. Qualitative analysis used an iterative inductive/deductive approach. RESULTS: Findings were summarized in a conceptual framework and suggested that HS's current 2-generational approach is useful for families when addressing multilevel factors affecting FNI. The role of the family advocate is essential. In addition to increasing access to nutritious foods, emphasis should also be placed on skills and education to decrease generational unhealthy behaviors. CONCLUSIONS AND IMPLICATIONS: Head Start intervenes in generational cycles of FNI by using the family advocate to add to skills building for 2-generational health. Other programs targeting underserved children can use a similar structure for the greatest impact on FNI.

Direct-to-patient telehealth equity: Reaching diverse pediatric populations in primary care.

INTRODUCTION: Telehealth is the use of electronic information and technology for long-distance clinical care. In direct-to-patient (DTP) telehealth, the patient initiates care from a personal computer or mobile device to a medical provider. While information on standard clinic-to-clinic telehealth exists, less is known about DTP telehealth in pediatric populations. Using quantitative and qualitative data, we examined DTP telehealth for low-income pediatric patient-families and compared the experience of English and non-English speakers. METHOD: Telehealth visits for acute and preventive care took place from April 2020 to May 2020 at a pediatric primary care clinic (80% Medicaid-insured, 40% non-English-speaking). Patients and primary care providers conducted the visit through the clinic's portal or other platforms (WhatsApp, FaceTime, Zoom). Providers completed an electronic survey with patient feedback about the telehealth experience and their own observations. An iterative inductive/deductive approach informed a coding scheme for free-text survey responses consisting of five domains. RESULTS: REDCap surveys were completed for 258 (52%) of telehealth visits. There was an overrepresentation of English visits compared to the overall clinic population and the majority of visits were via mobile phone. Visits with English speakers utilized the patient portal and had positive process ease ratings more often than those with non-English speakers. Providers rated most telehealth visits as satisfactory, with contributing elements including family call environment, technology process and experience, value added, and barriers. DISCUSSION: Expanding telehealth in pediatrics without worsening health disparities requires building digital health that is user-friendly on mobile technology, facilitating patient preferred language, and simplifying logistical processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).