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The Role of Parent Engagement in Overcoming Barriers to Care for Youth Returning Home After Incarceration

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Abstract

We sought to understand the role of parent engagement in overcoming barriers to care for youth re-entering the community following incarceration. For this mixed methods study, we conducted quantitative surveys on healthcare needs and access with youth (n = 50) at 1-month post-incarceration, and semi-structured interviews with a subset of these youth (n = 27) and their parents (n = 34) at 1, 3, and 6-months post-incarceration (total 94 interviews). Differences by race/ethnicity and gender were assessed using Chi square test of proportions. We performed thematic analysis of interview transcripts to examine the role of parent engagement in influencing youths’ access to healthcare during reentry. Most youth were from racial/ethnic minority groups and reported multiple ACEs. Girls, compared to boys, had higher ACE scores (p = 0.03), lower family connectedness (p = 0.03), and worse general health (p = 0.02). Youth-identified barriers to care were often parent-dependent and included lack of: affordable care (22%), transportation (16%), and accompaniment to health visits (14%). Two major themes emerged from the qualitative interviews: (1) parents motivate youth to seek healthcare during reentry and (2) parents facilitate the process of youth seeking healthcare during reentry. Parents are instrumental in linking youth to healthcare during reentry, dispelling prevailing myths that parents of incarcerated youth are inattentive and that youth do not want their help. Efforts that support and enhance parent engagement in access to care during reentry, such as by actively involving parents in pre-release healthcare planning, may create stronger linkages to care.

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Acknowledgements

The authors would like to thank participating families and community partners at the probation and health department. Dr. Barnert’s time was supported by a KL2 Grant from the UCLA CTSI (NIH KL2U000124), by a NIDA Career Development Award (K23 DA045747-01), and by the California Community Foundation. UCLA/Drew medical student Bria Pettway received a UCLA CTSI TL1 Summer Fellowship and UCLA medical student Nivedita Keshav participated in the UCLA David Geffen School of Medicine STTP.

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Authors and Affiliations

  1. Department of Pediatrics, David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA

    Elizabeth S. Barnert, Nathalie Lopez, Bria Pettway, Nivedita Keshav & Paul J. Chung

  2. Children’s Discovery & Innovation Institute, Mattel Children’s Hospital, 757 Westwood Plaza, Los Angeles, CA, 90095, USA

    Elizabeth S. Barnert, Nathalie Lopez, Bria Pettway, Nivedita Keshav & Paul J. Chung

  3. Department of Social Welfare, UCLA Luskin School of Public Affairs, UCLA, 337 Charles E Young Dr, Los Angeles, CA, 90095, USA

    Laura S. Abrams

  4. Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA

    Bonnie Zima

  5. Department of Health Policy & Management, UCLA Fielding School of Public Health, UCLA, 650 Charles E Young Dr, Los Angeles, CA, 90095, USA

    Paul J. Chung

  6. RAND Health, RAND Corporation, 1776 Main St, Santa Monica, CA, 90401, USA

    Paul J. Chung

  7. Department of Health Systems Science, Kaiser Permanente School of Medicine, 100 S Los Robles Ave #501, Pasadena, CA, 91101, USA

    Paul J. Chung

Authors
  1. Elizabeth S. Barnert
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  2. Nathalie Lopez
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  3. Bria Pettway
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  4. Nivedita Keshav
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  5. Laura S. Abrams
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  6. Bonnie Zima
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  7. Paul J. Chung
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Correspondence to Elizabeth S. Barnert.

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Implication and contributions Findings underscore the vital role of parents in promoting youths’ healthcare linkages after incarceration. Approaches that leverage parent engagement such as involving parents in pre-release healthcare planning are promising.

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Barnert, E.S., Lopez, N., Pettway, B. et al. The Role of Parent Engagement in Overcoming Barriers to Care for Youth Returning Home After Incarceration. J Community Health 45, 329–337 (2020). https://doi.org/10.1007/s10900-019-00747-1

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