Shades of Care: Understanding how BIPOC mothers and children experience paediatric care in Ontario, Canada

Abstract

BACKGROUND: Race and ethnicity are determinants of health which play significant roles in shaping the quality of care and health outcomes for a child. In Canada’s increasingly diversifying patient populations, it has been observed that definitions and experiences of health vary. Lack of understanding of these variations within the context of paediatric care can set children on a trajectory for negative health outcomes in the future, whereas their acknowledgement and active incorporation in care has the potential to orient children on a path towards holistic wellness.

OBJECTIVES: The purpose of this study was to gain an understanding of how BIPOC mothers and children experience paediatric care in Ontario. It additionally aimed to explore how BIPOC mothers perceive the provider-patient relationship and what their needs and expectations are in these encounters in order to positively engage with and receive paediatric healthcare services.

METHODS: The participant sample consisted of BIPOC mothers residing in Ontario who have required paediatric care for their children (ages 0- 5). Fourteen semi-structured interviews occurred via video call or over-the-phone. Semi-structured interviews were conducted to allow participants the opportunity to authentically share their experiences, safely and without judgement. Participants’ stories were inductively coded and examined through narrative analysis to discern how BIPOC mothers represent their experiences of acquiring paediatric care.

RESULTS: Participants shared multi-dimensional definitions of health in the context of their own children, which influenced their perceptions of healthcare experiences. Provider-patient interactions were ultimately a central component of the patient experience, with needs such as respect and compassionate bedside manner being universal. Positive experiences within the provider-patient relationship tended to be as a result of individual providers’ efforts and commitment to their patients. Healthcare providers were described as influencing participants’ abilities to lay a strong foundation for their children’s future. This is of particular significance as BIPOC mothers have expressed an increased sense of responsibility in advocating for and working towards optimal states of wellness for their children. Participants recalled building or engaging with communities of support to ensure their children’s wellness, and healthcare providers were suggested to become a central part of these communities, as opposed to simply existing on the periphery.

CONTRIBUTIONS: This study enables a comprehensive understanding of how BIPOC mothers conceptualize “health” for their children, as well as how they experience paediatric care in Ontario and how they feel about these interactions. Contributions of this research are 3-pronged: (1) enhancing cross-cultural understanding in paediatric care; (2) identifying the healthcare needs of paediatric patients and their families; and (3) informing clinical practice. This study also provides direction as to what sorts of approaches must be taken in order to sustainably implement culturally collaborative paediatric care in Ontario.