Parent activation and pediatric primary care outcomes for vulnerable children: A mixed methods study.
Lisa Ross DeCamp, Nakiya Showell, Sashini K Godage and 4 others
PMID 31288957WHAT IT FOUND
Parent activation scores showed no link to pediatric care outcomes for English-speaking parents.
For Spanish-speaking parents, higher scores oddly correlated with children being overweight. Interviews revealed the measure fails to capture cultural barriers and healthcare system navigation challenges.
Key findings
01Among English-speaking parents, no pediatric primary care outcomes were associated with parent activation scores.
02For Spanish-speaking parents, higher activation scores were associated with children being overweight and lower scores with fair or poor child health status.
03Qualitative interviews showed structural barriers like insurance complexity and lack of prompt sick care access influenced outcomes more than parent engagement did.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in a single clinic specifically designed to support immigrant and low-income families, so barriers were likely lower than in typical settings. The sample size may have been too small to detect subtle associations between activation and outcomes. The P-PAM was not validated for this specific population and lacked a standardized Spanish version from the licensor. Participants were parents already engaged in primary care, excluding those who do not attend.
Declared interests
The P-PAM is licensed by Insignia Health, which gave permission for its use. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not interpret higher P-PAM scores in Spanish-speaking families as evidence of better health management or outcomes. The study found these scores were associated with children being overweight, suggesting the measure may be tracking acculturation rather than true activation.