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Research Article| Volume 66, P6-14, September 2022

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Parent-to-parent peer support for children and youth with special health care needs: Preliminary evaluation of a family partner program in a healthcare system

  • McLean D. Pollock, PhD, MSW
    McLean D. Pollock
    Correspondence
    Corresponding author at: Duke Psychiatry, DUMC, Box# 102506, Durham, NC 27710, United States of America.
    Contact
    Affiliations
    Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
    Search for articles by this author
  • David Ming, MD
    David Ming
      Affiliations
      Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States of America
      Search for articles by this author
    • Richard J. Chung, MD
      Richard J. Chung
        Affiliations
        Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States of America
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      • Gary Maslow, MD, MPH
        Gary Maslow
          Affiliations
          Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America

          Department of Pediatrics, Duke University School of Medicine, Durham, NC, United States of America
          Search for articles by this author
        Published:May 19, 2022DOI:https://doi.org/10.1016/j.pedn.2022.05.008
        Parent-to-parent peer support for children and youth with special health care needs: Preliminary evaluation of a family partner program in a healthcare system
        Previous ArticleThe application of pediatric early warning score (PEWS) in emergency observation room
        Next ArticleNew insights on growth trajectory in infants with complex congenital heart disease
            Advertisement

            Highlights

            • •
              The Family Partner model enhances patient- and family-centered care for CYSHCN
            • •
              The Family Partner model can be implemented across health care settings
            • •
              Family Partners provide support and information for patients and families
            • •
              Family Partners communicate patient needs and service gaps to providers
            • •
              Family Partner champions facilitate successful implementation of this novel role

            Abstract

            Purpose

            Children and youth with special health care needs (CYSHCN) have complex care and coordination needs that are often managed by parents or primary caregivers. This study describes a parent-to-parent peer support pilot program for parents of CYSHCN implemented in both outpatient and inpatient settings across a large health system.

            Design & methods

            Retrospective data from the Family Partner Program documentation in patient health records are described. Descriptions about the encounters and types of support provided are also reviewed using qualitative descriptive analysis.

            Results

            Three Family Partners conducted 203 encounters with parents of 90 CYSHCN over six months. Family Partners provided both emotional and tangible support. Primary themes discussed included the persistent care, coordination and management needs related to parenting a child with complex care needs, the subsequent worry and stress about their child and family, and the need for stress management and self-care.

            Conclusion

            This study provides early evidence that implementation of a parent-to-parent peer support program for parents of CYSHCN in a large, academic medical center is feasible. Family Partners enhanced their healthcare team's ability to provide patient- and family-centered support for pediatric patients and their families through the provision of emotional and tangible support.

            Practice implications

            Family Partners, who are trained in effective use of the shared experience, the health coach model, and healthcare systems, and who are supported by a strong supervisory team, are ideally suited to support families and patients as they address their concerns and unmet needs and navigate complex health circumstances.

            Keywords

            • Parent peer support
            • Children and youth with special health care needs
            • Pilot
            • Family-centered care
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            References

              • Ainbinder J.G.
              • Blanchard L.W.
              • Singer G.H.S.
              • Sullivan M.E.
              • Powers L.K.
              • Marquis J.G.
              • Santelli B.
              A qualitative study of parent to parent support for parents of children with special needs.
              Journal of Pediatric Psychology. 1998; 23: 99-109
              https://doi.org/10.1093/jpepsy/23.2.99
              View in Article
              • Scopus (128)
              • PubMed
              • Crossref
              • Google Scholar
              • Akre C.
              • Polvinen J.
              • Ullrich N.J.
              • Rich M.
              Children’s at home: pilot study assessing dedicated social media for parents of adolescents with neurofibromatosis type 1.
              Journal of Genetic Counseling. 2018; 27: 505-517
              https://doi.org/10.1007/s10897-018-0213-0
              View in Article
              • Scopus (9)
              • PubMed
              • Crossref
              • Google Scholar
              • Allicock M.
              • Golin C.E.
              • Kaye L.
              • Grodensky C.
              • Blackman L.T.
              • Thibodeaux H.
              SafeTalk: Training peers to deliver a motivational interviewing HIV prevention program.
              Health Promotion Practice. 2017; 18: 410-417
              https://doi.org/10.1177/1524839916663486
              View in Article
              • Scopus (4)
              • PubMed
              • Crossref
              • Google Scholar
              • Allicock M.
              • Kaye L.
              • Johnson L.S.
              • Carr C.
              • Alick C.
              • Gellin M.
              • Campbell M.
              The use of motivational interviewing to promote peer-to-peer support for cancer survivors.
              Clinical Journal of Oncology Nursing. 2012; 16: E156-E163
              https://doi.org/10.1188/12.cjon.e156-e163
              View in Article
              • Scopus (10)
              • PubMed
              • Crossref
              • Google Scholar
              • Allshouse C.
              • Comeau M.
              • Rodgers R.
              • Wells N.
              Families of children with medical complexity: A view from the front lines.
              Pediatrics. 2018; 141: S195-S201
              https://doi.org/10.1542/peds.2017-1284D
              View in Article
              • Scopus (67)
              • PubMed
              • Crossref
              • Google Scholar
              • Barnett M.L.
              • Kia-Keating M.
              • Ruth A.
              • Garcia M.
              Promoting equity and resilience: Wellness navigators’ role in addressing adverse childhood experiences.
              Clinical Practice in Pediatric Psychology. 2020; 8: 176-188
              https://doi.org/10.1037/cpp0000320
              View in Article
              • Scopus (11)
              • PubMed
              • Crossref
              • Google Scholar
              • Barnett M.L.
              • Lau A.S.
              • Miranda J.
              Lay health worker involvement in evidence-based treatment delivery: A conceptual model to address disparities in Care.
              Annual Review of Clinical Psychology. 2018; 14: 185-208
              https://doi.org/10.1146/annurev-clinpsy-050817-084825
              View in Article
              • Scopus (63)
              • PubMed
              • Crossref
              • Google Scholar
              • Baron Nelson M.
              • Riley K.
              • Arellano K.
              Adding a parent to the brain tumor team: Evaluating a peer support intervention for parents of children with brain tumors.
              Journal of Pediatric Oncology Nursing. 2018; 35: 218-228
              https://doi.org/10.1177/1043454218762797
              View in Article
              • Scopus (13)
              • PubMed
              • Crossref
              • Google Scholar
              • Bray L.
              • Carter B.
              • Sanders C.
              • Blakea L.
              • Keegan K.
              Parent-to-parent peer support for parents of children with a disability: A mixed method study.
              Patient Education and Counseling. 2017; 100: 1537-1543
              https://doi.org/10.1016/j.pec.2017.03.004
              View in Article
              • Scopus (43)
              • PubMed
              • Crossref
              • Google Scholar
              • Carnevale F.A.
              • Rehm R.S.
              • Kirk S.
              • McKeever P.
              What we know (and do not know) about raising children with complex continuing care needs.
              Journal of Child Health Care. 2008; 12: 4-6
              https://doi.org/10.1177/1367493508088552
              View in Article
              • Scopus (55)
              • PubMed
              • Crossref
              • Google Scholar
              • Carter B.
              • Coad J.
              • Bray L.
              • Goodenough T.
              • Moore A.
              • Anderson C.
              • Widdas D.
              Home-based Care for Special Healthcare Needs: Community Children’s nursing services.
              Nursing Research. 2012; 61: 260-268
              https://doi.org/10.1097/NNR.0b013e31825b6848
              View in Article
              • Scopus (17)
              • PubMed
              • Crossref
              • Google Scholar
              • Cousino M.K.
              • Hazen R.A.
              Parenting stress among caregivers of children with chronic illness: A systematic review.
              Journal of Pediatric Psychology. 2013; 38: 809-828
              https://doi.org/10.1093/jpepsy/jst049
              View in Article
              • Scopus (473)
              • PubMed
              • Crossref
              • Google Scholar
              • Dennis C.-L.
              Peer support within a health care context: A concept analysis.
              International Journal of Nursing Studies. 2003; 40: 321-332
              https://doi.org/10.1016/S0020-7489(02)00092-5
              View in Article
              • Scopus (684)
              • PubMed
              • Crossref
              • Google Scholar
              • Dodds R.L.
              • Yarbrough D.V.
              • Quick N.
              Lessons learned: Providing peer support to culturally diverse families of children with disabilities or special health Care needs.
              Social Work. 2018; 63: 261-264
              https://doi.org/10.1093/sw/swy019
              View in Article
              • PubMed
              • Google Scholar
              • Donegan A.
              • Boyle B.
              • Crandall W.
              • Dotson J.L.
              • Lemont C.
              • Moon T.
              • Kim S.C.
              Connecting families: A pediatric IBD Center’s development and implementation of a volunteer parent Mentor program.
              Inflammatory Bowel Diseases. 2016; 22: 1151-1156
              https://doi.org/10.1097/MIB.0000000000000733
              View in Article
              • Scopus (8)
              • PubMed
              • Crossref
              • Google Scholar
              • Dorsey S.
              • Pullmann M.D.
              • Deblinger E.
              • Berliner L.
              • Kerns S.E.
              • Thompson K.
              • Garland A.F.
              Improving practice in community-based settings: A randomized trial of supervision – Study protocol.
              Implementation Science. 2013; 8: 89
              https://doi.org/10.1186/1748-5908-8-89
              View in Article
              • Scopus (67)
              • PubMed
              • Crossref
              • Google Scholar
              • Elo S.
              • Kyngäs H.
              The qualitative content analysis process.
              Journal of Advanced Nursing. 2008; 62: 107-115
              https://doi.org/10.1111/j.1365-2648.2007.04569.x
              View in Article
              • Scopus (10070)
              • PubMed
              • Crossref
              • Google Scholar
              • Golden S.L.
              • Nageswaran S.
              Caregiver voices: Coordinating care for children with complex chronic conditions.
              Clinical Pediatrics. 2012; 51: 723-729
              https://doi.org/10.1177/0009922812445920
              View in Article
              • Scopus (50)
              • PubMed
              • Crossref
              • Google Scholar
              • Graneheim U.H.
              • Lundman B.
              Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness.
              Nurse Education Today. 2004; 24: 105-112
              https://doi.org/10.1016/j.nedt.2003.10.001
              View in Article
              • Scopus (10672)
              • PubMed
              • Crossref
              • Google Scholar
              • Hatzmann J.
              • Heymans H.S.A.
              • Ferrer-i-Carbonell A.
              • van Praag B.M.S.
              • Grootenhuis M.A.
              Hidden consequences of success in pediatrics: Parental health-related quality of life—results from the care project.
              Pediatrics. 2008; 122: e1030-e1038
              https://doi.org/10.1542/peds.2008-0582
              View in Article
              • Scopus (134)
              • PubMed
              • Crossref
              • Google Scholar
              • Hinton D.
              • Kirk S.
              Living with uncertainty and hope: A qualitative study exploring parents’ experiences of living with childhood multiple sclerosis.
              Chronic Illness. 2017; 13: 88-99
              https://doi.org/10.1177/1742395316664959
              View in Article
              • Scopus (30)
              • PubMed
              • Crossref
              • Google Scholar
              • Hoagwood K.E.
              • Cavaleri M.A.
              • Olin S.S.
              • Burns B.J.
              • Slaton E.
              • Gruttadaro D.
              • Hughes R.
              Family support in children’s mental health: A review and synthesis.
              Clinical Child and Family Psychology Review. 2010; 13: 1-45
              https://doi.org/10.1007/s10567-009-0060-5
              View in Article
              • Scopus (145)
              • PubMed
              • Crossref
              • Google Scholar
              • January S.A.
              • Duppong Hurley K.
              • Stevens A.L.
              • Kutash K.
              • Duchnowski A.J.
              • Pereda N.
              Evaluation of a community-based peer-to-peer support program for parents of at-risk youth with emotional and behavioral difficulties.
              Journal of Child and Family Studies; New York. 2016; 25: 836-844
              https://doi.org/10.1007/s10826-015-0271-y
              View in Article
              • Scopus (16)
              • Crossref
              • Google Scholar
              • Kelleher K.
              • Schoenwald S.
              • Rolls-Reutz J.
              • Landsverk J.
              • Glisson C.
              • Mayberg S.
              Family Advocacy, Support and Education in Children’s Mental Health: Results of a National Survey.
              35(1–2). Administration and Policy in Mental Health and Mental Health Services Research, New York2008: 73-83
              https://doi.org/10.1007/s10488-007-0149-4
              View in Article
              • Google Scholar
              • Kingsnorth S.
              • Gall C.
              • Beayni S.
              • Rigby P.
              Parents as transition experts? Qualitative findings from a pilot parent-led peer support group.
              Child: Care, Health and Development. 2011; 37: 833-840
              https://doi.org/10.1111/j.1365-2214.2011.01294.x
              View in Article
              • Scopus (69)
              • PubMed
              • Crossref
              • Google Scholar
              • Kutash K.
              • Duchnowski A.J.
              • Green A.L.
              • Ferron J.
              Effectiveness of the parent connectors program: Results from a randomized controlled trial.
              School Mental Health. 2013; 5: 192-208
              https://doi.org/10.1007/s12310-013-9106-4
              View in Article
              • Scopus (27)
              • Crossref
              • Google Scholar
              • Lammers E.J.
              • Zickafoose J.S.
              • Peterson G.G.
              • Blue L.
              • Stewart K.A.
              • Kranker K.
              Parent partners: Evaluation of a novel peer-support intervention for the caregivers of children hospitalized for behavioral health conditions.
              Academic Pediatrics. 2019; 19: 908-916
              https://doi.org/10.1016/j.acap.2019.06.001
              View in Article
              • Scopus (9)
              • PubMed
              • Abstract
              • Full Text
              • Full Text PDF
              • Google Scholar
              • Levine C.
              A 21st century job description for family caregiving.
              in: Health Affairs Blog. 2019, June 14
              https://www.healthaffairs.org/do/10.1377/hblog20190612.959252/full/?utm_source=newsletter&utm_medium=email&utm_content=A+21st+Century+Job+Description+for+Family+Caregiving&utm_campaign=2019.07.11_CSHCN_Network_Newsletter&
              View in Article
              • Google Scholar
              • McConnell D.
              • Savage A.
              • Breitkreuz R.
              • Sobsey D.
              Sustainable family care for children with disabilities.
              Journal of Child and Family Studies. 2016; 25: 530-544
              https://doi.org/10.1007/s10826-015-0245-0
              View in Article
              • Scopus (9)
              • Crossref
              • Google Scholar
              • Miller A.R.
              • Condin C.J.
              • McKellin W.H.
              • Shaw N.
              • Klassen A.F.
              • Sheps S.
              Continuity of care for children with complex chronic health conditions: Parents’ perspectives.
              BMC Health Services Research. 2009; 9: 242
              https://doi.org/10.1186/1472-6963-9-242
              View in Article
              • Scopus (118)
              • PubMed
              • Crossref
              • Google Scholar
              • Nicholas D.B.
              • Keilty K.
              An evaluation of dyadic peer support for caregiving parents of children with chronic lung disease requiring technology assistance.
              Vol. 44. Haworth Press Inc., 2013: 245-259
              View in Article
              • Google Scholar
              • Nygård C.
              • Clancy A.
              Unsung heroes, flying blind—A metasynthesis of parents’ experiences of caring for children with special health-care needs at home.
              Journal of Clinical Nursing. 2018; 27: 3179-3196
              https://doi.org/10.1111/jocn.14512
              View in Article
              • Scopus (20)
              • PubMed
              • Crossref
              • Google Scholar
              • Perrin J.M.
              • Bloom S.R.
              • Gortmaker S.L.
              The increase of childhood chronic conditions in the United States.
              JAMA. 2007; 297: 2755-2759
              https://doi.org/10.1001/jama.297.24.2755
              View in Article
              • Scopus (381)
              • PubMed
              • Crossref
              • Google Scholar
              • Pizur-Barnekow K.
              • Darragh A.
              • Johnston M.
              “I cried because I didn’t know if I could take care of him”: Toward a taxonomy of interactive and critical health literacy as portrayed by caregivers of children with special health care needs.
              Journal of Health Communication. 2011; 16: 205-221
              https://doi.org/10.1080/10810730.2011.604386
              View in Article
              • Scopus (14)
              • PubMed
              • Crossref
              • Google Scholar
              • Pordes E.
              • Gordon J.
              • Sanders L.M.
              • Cohen E.
              Models of care delivery for children with medical complexity.
              Pediatrics. 2018; 141: S212-S223
              https://doi.org/10.1542/peds.2017-1284F
              View in Article
              • Scopus (60)
              • PubMed
              • Crossref
              • Google Scholar
              • Quittner A.L.
              • Espelage D.L.
              • Opipari L.C.
              • Carter B.
              • Eid N.
              • Eigen H.
              Role strain in couples with and without a child with a chronic illness: Associations with marital satisfaction, intimacy, and daily mood.
              Health Psychology. 1998; 17: 112-124
              https://doi.org/10.1037/0278-6133.17.2.112
              View in Article
              • Scopus (158)
              • PubMed
              • Crossref
              • Google Scholar
              • Remedios C.
              • Willenberg L.
              • Zordan R.
              • Murphy A.
              • Hessel G.
              • Philip J.
              A pre-test and post-test study of the physical and psychological effects of out-of-home respite care on caregivers of children with life-threatening conditions.
              Palliative Medicine. 2015; 29: 223-230
              https://doi.org/10.1177/0269216314560008
              View in Article
              • Scopus (36)
              • PubMed
              • Crossref
              • Google Scholar
              • Roman S.B.M.
              • Dworkin P.H.
              • Dickinson P.R.
              • Rogers S.C.M.
              Analysis of care coordination needs for families of children with special health care needs.
              Journal of Developmental. 2020; 41: 58-64
              https://doi.org/10.1097/DBP.0000000000000734
              View in Article
              • Google Scholar
              • Romley J.A.
              • Shah A.K.
              • Chung P.J.
              • Elliott M.N.
              • Vestal K.D.
              • Schuster M.A.
              Family-provided health care for children with special health care needs.
              Pediatrics. 2017; 139
              https://doi.org/10.1542/peds.2016-1287
              View in Article
              • Scopus (54)
              • PubMed
              • Crossref
              • Google Scholar
              • Santelli B.
              • Turnbull A.P.
              • Marquis J.G.
              • Lerner E.P.
              Parent to parent programs: A unique form of mutual support.
              Infants & Young Children. 1995; 8: 48-57
              View in Article
              • Scopus (26)
              • Crossref
              • Google Scholar
              • Shepardson R.L.
              • Johnson E.M.
              • Possemato K.
              • Arigo D.
              • Funderburk J.S.
              Perceived barriers and facilitators to implementation of peer support in veterans health administration primary care-mental health integration settings.
              Psychological Services. 2019; 16: 433-444
              https://doi.org/10.1037/ser0000242
              View in Article
              • Scopus (20)
              • PubMed
              • Crossref
              • Google Scholar
              • Shue S.A.
              • McGuire A.B.
              • Matthias M.S.
              Facilitators and barriers to implementation of a peer support intervention for patients with chronic pain: A qualitative study.
              Pain Medicine. 2019; 20: 1311-1321
              https://doi.org/10.1093/pm/pny229
              View in Article
              • Scopus (5)
              • PubMed
              • Crossref
              • Google Scholar
              • Toms G.
              • Totsika V.
              • Hastings R.
              • Healy H.
              Access to services by children with intellectual disability and mental health problems: Population-based evidence from the UK.
              Journal of Intellectual & Developmental Disability. 2015; 40: 239-247
              https://doi.org/10.3109/13668250.2015.1045460
              View in Article
              • Scopus (14)
              • Crossref
              • Google Scholar
              • Trollvik A.
              • Severinsson E.
              Parents’ experiences of asthma: Process from chaos to coping.
              Nursing & Health Sciences. 2004; 6: 93-99
              https://doi.org/10.1111/j.1442-2018.2004.00179.x
              View in Article
              • Scopus (44)
              • PubMed
              • Crossref
              • Google Scholar
              • Woodgate R.L.
              • Edwards M.
              • Ripat J.D.
              • Borton B.
              • Rempel G.
              Intense parenting: A qualitative study detailing the experiences of parenting children with complex care needs.
              BMC Pediatrics. 2015; 15: 197
              https://doi.org/10.1186/s12887-015-0514-5
              View in Article
              • Scopus (115)
              • PubMed
              • Crossref
              • Google Scholar

            Article info

            Publication history

            Published online: May 19, 2022
            Accepted: May 6, 2022
            Received in revised form: April 16, 2022
            Received: January 4, 2022

            Identification

            DOI: https://doi.org/10.1016/j.pedn.2022.05.008

            Copyright

            © 2022 Elsevier Inc. All rights reserved.

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