Urban, Low-Income, African American Well-Child Care: Comparison of Parent and Healthcare Provider Experiences and Expectations

Kara S. Koschmann, Cynthia J. Peden-McAlpine, Mary Chesney, Susan M. Mason, Mary C. Hooke

Research output: Contribution to journalArticlepeer-review


Objectives: Urban, low-income, African American children and parents report lower quality primary care and face negative social determinants of health. High-quality well-child care is critical for this population. The purpose of this qualitative study was to compare and contrast parent and health care provider experiences of well-child care for urban, low-income, African American families to better understand the complex factors involved in care quality and health outcomes. Methods: Two data sets were analyzed using conventional content analysis, parent focus group data, and provider interviews. After analysis, results were sorted into similar categories, and convergence coding was completed to identify areas of agreement, partial agreement, dissonance, and silence. Results: Thirty-five parents took part in four focus groups, and nine providers were interviewed. Following convergence coding, five categories and 31 subcategories were identified. The five categories included: social determinants of health, sources of advice and support, challenges with the healthcare system, parent-provider relationships, and anticipatory guidance topics. Conclusions for Practice: Triangulation demonstrated convergence between parents and providers understanding of the concepts and functions of well-child care, however the prominence and meaning varied within each category and sub-category. The variance in agreement, areas of silence, and dissonance shed light on why the population reports lower overall quality primary care.

Original languageEnglish (US)
Pages (from-to)1677-1688
Number of pages12
JournalMaternal and child health journal
Issue number11
Early online dateAug 17 2021
StatePublished - Nov 2021

Bibliographical note

Funding Information:
This study was funded by the Robert Wood Johnson Foundation Future of Nursing Scholars program, the Carol Easley Denny Award from St. Catherine University, and the Sigma Theta Tau—Zeta Chapter.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • African American
  • Care quality
  • Qualitative
  • Social determinants of health
  • Well-child care


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