Journal of Immigrant and Minority Health

, Volume 13, Issue 3, pp 526–532

911 (Nueve Once): Spanish-Speaking Parents’ Perspectives on Prehospital Emergency Care for Children

  • Jennifer Watts
  • John D. Cowden
  • A. Paula Cupertino
  • M. Denise Dowd
  • Chris Kennedy
Original Paper

Abstract

Racial, ethnic and language-based disparities occur throughout the US health system. Pediatric prehospital emergency medical services are less likely to be used by Latinos. We identified perceptions of and barriers to prehospital pediatric emergency care (911) access among Spanish-speaking parents. A qualitative study involving six focus groups was conducted. Spanish-speaking parents participated with a bilingual moderator. Topics discussed included experiences, knowledge, beliefs, fears, barriers, and improvement strategies. All groups were audiotaped, transcribed, and reviewed for recurring themes. Forty-nine parents participated. Though parents believed 911 was available to all, many were uncertain how to use it, and what qualified as an emergency. Barriers included language discordance, fear of exposing immigration status, and fear of financial consequences. Parents strongly desired to learn more about 911 through classes, brochures, and media campaigns. Prehospital emergency care should be available to all children. Further quantitative studies may help solidify the identified barriers and uncover areas needing improvement within Emergency Medical Systems. Addressing barriers to 911 use in Spanish-speaking communities could improve the equity of health care delivery, while also decreasing the amount of non-emergency 911 use.

Keywords

Disparities Pediatrics Emergency medicine Parental attitudes Parental beliefs 

References

  1. 1.
    Shin H, Bruno R. Language use and English-speaking ability: census 2000 brief. Available at www.census.gov/prod/2003pubs/c2kbr (2009).
  2. 2.
    Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origin for the United States: April 1, 2000 to July 1, 2009. http://www.census.gov/popest/national/asrh (2009). Retrieved 23 May 2009 from US census Bureau population estimate.
  3. 3.
    Flores G, Vega LR. Barriers to health care access for Latino children. Fam Med. 1998;30:196–205.PubMedGoogle Scholar
  4. 4.
    Flores G, Fuentes-Afflick E, Barbot O, et al. The health of Latino children: urgent priorities, unanswered questions, and a research agenda. JAMA. 2002;288(1):82–90.PubMedCrossRefGoogle Scholar
  5. 5.
    Smedley B, Stith A, Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. Committee on understanding and eliminating racial and ethnic disparities in health care. Institute of Medicine. Washington, DC: National Academies Press; 2003.Google Scholar
  6. 6.
    Institute of Medicine. Crossing the quality chasm a new health system for the twenty-first century. Washington, DC: National Academy Press; 2001.Google Scholar
  7. 7.
    Quintana JM, Goldmann D, Homer C. Social disparities in the use of diagnostic tests for children with gastroenteritis. Int J Qual Health Care. 1997;9:419–25.PubMedGoogle Scholar
  8. 8.
    Ng B, Dimsdale JE, Shragg GP, et al. Ethnic differences in analgesic consumption for postoperative pain. Psychosom Med. 1996;58:125–9.PubMedGoogle Scholar
  9. 9.
    Chan KS, Keeler E, Schonlau M, et al. How do ethnicity and primary language spoken at home affect management practices and outcomes in children and adolescents with asthma? Arch Pediatr Adolesc Med. 2005;159:283–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Vadeboncoeur T, Richman PB, Darkoh M, et al. Bystander cardiopulmonary resuscitation for out-of-hospital cardiac arrest in the Hispanic vs the non-Hispanic populations. Am J Emerg Med. 2008;26(6): 655–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Clark LT, Bellam SV, Shah AH, et al. Analysis of prehospital delay among inner-city patients with symptoms of myocardial infarction: implications for therapeutic intervention. J Natl Med Assoc. 1992;84(11):931–7.PubMedGoogle Scholar
  12. 12.
    McConnel C, Wilson R. Patterns of use of EMS transport. Am J Emerg Med. 2001;19(1):84–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Chan TC, Krishel SJ, Bramwell KJ, et al. Survey of illegal immigrants seen in an emergency department. West J Med. 1996;164(3):212–6.PubMedGoogle Scholar
  14. 14.
    Wyandotte County, Kansas. http://quickfacts.census.gov/qfd/states/20/20209.html (2009). Retrieved 23 May 2009 from US census Bureau State and county qucikfacts.
  15. 15.
    Household Income 1999, for Wyandotte County Neighborhoods. http://www.wycokck.org/dept.aspx?id=3140&banner=15284 (2008). Retreived 18 July 2008 from economic tables for Wyandotte County, Kansas.
  16. 16.
    Biernacki P, Waldorf D. Snowball sampling: problems and techniques of chain referral sampling. Sociol Methods Res. 1981;10:141–63.Google Scholar
  17. 17.
    Lopez GI, Figueroa M, Conner SE, et al. Translation barriers in conducting qualitative research with Spanish speakers. Qual Health Res. 2008;18(12):1729–37.PubMedCrossRefGoogle Scholar
  18. 18.
    Strauss AL. Basics of qualitative research: techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks: Sage Publications; 1998.Google Scholar
  19. 19.
    Harkness JA. Questionnaire translation. In: Harkness JA, van der Vijver FJR, Mohler PPh, editors. Cross-cultural survey methods. New Jersey: John Wiley & Sons; 2003.Google Scholar
  20. 20.
    Oberlander TF, Pless IB, Dougherty GE. Advice seeking and appropriate use of a pediatric emergency department. Arch Pediatr Adolesc Med. 1993;147(8):863–7.Google Scholar
  21. 21.
    Arreola-Risa C, Mock CM, Padilla D, et al. Trauma care systems in urban Latin America: the priorities should be prehospital and emergency room management. J Trauma. 1995;39(3):457–62.PubMedCrossRefGoogle Scholar
  22. 22.
    Committee on Pediatric Emergency Medicine. Overcrowding crisis in our nation’s emergency departments: is our safety net unraveling? Pediatrics. 2004;114(3):878–88.CrossRefGoogle Scholar
  23. 23.
    Richardson LD, Irvin CB, Tamayo-Sarver JH. Racial and ethnic disparities in the clinical practice of emergency medicine. Acad Emerg Med. 2008;10(11):1184–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jennifer Watts
    • 1
  • John D. Cowden
    • 2
  • A. Paula Cupertino
    • 3
  • M. Denise Dowd
    • 1
  • Chris Kennedy
    • 1
  1. 1.Division of Emergency MedicineChildren’s Mercy HospitalKansas CityUSA
  2. 2.Division of General PediatricsChildren’s Mercy HospitalKansas CityUSA
  3. 3.Division of Preventive Medicine and Public HealthKansas University Medical CenterKansas CityUSA

Personalised recommendations