Provider, Staff, and Parent Perspectives on the Feasibility, Utility, and Implementation of the Family Health Scale in Primary Care Pediatrics

Introduction: Improving child health involves focusing on family capacities and resources, including family health. This study aimed to assess (a) current practices for collecting family information in pediatric primary care settings, and (b) the feasibility, acceptability, and utility of a validated Family Health Scale-Short Form (FHS-SF) to screen for family health from clinic staff and parent perspectives. Method: We piloted the FHS-SF in two urban pediatric clinics in 2022. We interviewed four pediatricians and six staff members and piloted the survey with 25 parents. We employed an exploratory qualitative design that included data from provider and staff interviews and a descriptive quantitative component, including surveys with parents/caregivers. We analyzed interview transcripts with the Framework Analysis method and presented survey results with descriptive statistics. Results: Clinic providers and staff endorsed the importance of the family context in pediatric care and regularly asked household economic questions but did not routinely assess interpersonal health except during transitions (e.g., newborn/infancy and adolescent visits) and in the context of a custody change. Caregivers were, on average, 34 years old, primarily mothers (92%) and Black/African American (56%) or white (20%). Providers, staff, and caregivers found the FHS-SF questions to be acceptable. Providers suggested using the FHS-SF as a “conversation starter” or a tool to identify referrals. Staff provided suggestions for implementation. Discussion: The FHS-SF could be an effective tool in primary care pediatric settings, contributing to more family-focused care as a foundation for well-being early in the life course.