Maternal and Child Health Journal

, Volume 9, Issue 1, pp 49–57 | Cite as

Measuring Primary Care for Children of Latino Farmworkers: Reliability and Validity of the Parent’s Perceptions of Primary Care Measure (P3C)

Article

Abstract

This study evaluates the feasibility, reliability, and validity of the Parent’s Perceptions of Primary Care measure (P3C) in an underserved population: children of Latino farm workers. Bilingual research assistants verbally administered the P3C, as well as a measure of child health-related quality of life (HRQL: the PedsQL™ 4.0) and demographic questions to 297 Latino farm worker parents of young children, in San Diego and Imperial Counties. The P3C was found to be feasible, as measured by a very low percent of missing/do not know values. Internal consistency reliability for the Total Scale and most subscales was strong. The P3C’s validity was demonstrated through factor analysis of the subscales, by showing that scores were lower for children without a regular physician and for children experiencing foregone health care, and by demonstrating that P3C scores were related to HRQL. The P3C can be useful to various stakeholders in measuring primary care for vulnerable populations.

Keywords

primary care quality Latino child measurement migrant worker 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Starfield B. Public health and primary care: A framework for proposed linkages. Am J Public Health 1996;86(10):1365–9.Google Scholar
  2. 2.
    Starfield B, Simpson L. Primary care as part of US health services reform. JAMA 1993;269(24):3136–9.Google Scholar
  3. 3.
    Starfield B. Primary Care: Balancing Health Needs, Services, and Technology. New York: Oxford Universty Press, 1998.Google Scholar
  4. 4.
    Aday L. At Risk in America: The Health and Health Care Needs of Vulnerable Populations in the United States. San Francisco: Jossey-Bass, 1993.Google Scholar
  5. 5.
    Pappas G, Queen S, Hadden W, Fisher G. The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. N Engl J Med 1993;329(2):103–9.Google Scholar
  6. 6.
    Gould JB, Davey B, LeRoy S. Socioeconomic differentials and neonatal mortality: Racial comparison of California singletons. Pediatrics 1989;83(2):181–6.Google Scholar
  7. 7.
    Starfield B. Effects of poverty on health status. Bull N Y Acad Med 1992;68(1):17–24.Google Scholar
  8. 8.
    Brown R, Wyn R, Yu H, Valenzuela A, Dong L. Access to health insurance and health care for Mexican American children in immigrant families. In: Suarez-Orozco M, editor. Crossings: Mexican Immigration in Interdisciplinary Perspectives. Harvard University Press, 1998: 227–47.Google Scholar
  9. 9.
    Newacheck PW, Hughes DC, Hung YY, Wong S, Stoddard JJ. The unmet health needs of America’s children. Pediatrics 2000;105(4 Pt 2):989–97.Google Scholar
  10. 10.
    Stewart AL, Napoles-Springer A, Perez-Stable EJ. Interpersonal processes of care in diverse populations. Milbank Q 1999;77(3):305–39.Google Scholar
  11. 11.
    Ronsaville DS, Hakim RB. Well child care in the United States: racial differences in compliance with guidelines [In Process Citation]. Am J Public Health 2000;90(9):1436–43.Google Scholar
  12. 12.
    Zambrana RE, Dorrington C. Economic and social vulnerability of Latino children and families by subgroup: Implications for child welfare. Child Welfare 1998;77(1):5–27.Google Scholar
  13. 13.
    Berwick DM, James B, Coye MJ. Connections between quality measurement and improvement. Med Care 2003;41(1 Suppl):I30–8.Google Scholar
  14. 14.
    Homer CJ, Marino B, Cleary PD, et al. Quality of care at a children’s hospital: The parent’s perspective. Arch Pediatr Adolesc Med 1999;153(11):1123–9.Google Scholar
  15. 15.
    Dinkevich EI, Cunningham SJ, Crain EF. Parental perceptions of access to care and quality of care for inner-city children with asthma. J Asthma 1998;35(1):63–71.Google Scholar
  16. 16.
    Garwick AW, Kohrman C, Wolman C, Blum RW. Families’ recommendations for improving services for children with chronic conditions. Arch Pediatr Adolesc Med 1998;152(5):440–8.Google Scholar
  17. 17.
    Crain EF, Kercsmar C, Weiss KB, Mitchell H, Lynn H. Reported difficulties in access to quality care for children with asthma in the inner city. Arch Pediatr Adolesc Med 1998;152(4):333–9.Google Scholar
  18. 18.
    Seid M, Varni J, Olson-Bermudez L, et al. Parent’s Perceptions of Primary Care measure (P3C): Measuring parents’ experiences of pediatric primary care quality. Pediatrics 2001;108(2):264–70.Google Scholar
  19. 19.
    Institute of Medicine. Primary Care: America’s Health in a New Era. Washington, DC: National Academy Press, 1996.Google Scholar
  20. 20.
    Slesinger DP, Christenson BA, Cautley E. Health and mortality of migrant farm children. Soc Sci Med 1986;23(1):65–74.Google Scholar
  21. 21.
    Eshleman MJ, Davidhizar R. Life in migrant camps for children—A hazard to health. J Cult Divers 1997;4(1):13–7.Google Scholar
  22. 22.
    Slesinger DP. Health status and needs of migrant farm workers in the United States: A literature review. J Rural Health 1992;8(3):227–34.Google Scholar
  23. 23.
    Kupersmidt JB, Martin SL. Mental health problems of children of migrant and seasonal farm workers: A pilot study. J Am Acad Child Adolesc Psychiatry 1997;36(2):224–32.Google Scholar
  24. 24.
    Martin SL, Kupersmidt JB, Harter KS. Children of farm laborers: Utilization of services for mental health problems. Community Ment Health J 1996;32(4):327–40.Google Scholar
  25. 25.
    Woolfolk M, Hamard M, Bagramian RA, Sgan-Cohen H. Oral health of children of migrant farm workers in northwest Michigan. J Public Health Dent 1984;44(3):101–5.Google Scholar
  26. 26.
    Nurko C, Aponte-Merced L, Bradley EL, Fox L. Dental caries prevalence and dental health care of Mexican-American workers’ children. ASDC J Dent Child 1998;65(1):65–72.Google Scholar
  27. 27.
    Flores G, Abreu M, Olivar MA, Kastner B. Access barriers to health care for Latino children. Arch Pediatr Adolesc Med 1998;152(11):1119–25.Google Scholar
  28. 28.
    Mueller KJ, Patil K, Boilesen E. The role of uninsurance and race in healthcare utilization by rural minorities. Health Serv Res 1998;33(3 Pt 1):597–610.Google Scholar
  29. 29.
    Gwyther ME, Jenkins M. Migrant farmworker children: Health status, barriers to care, and nursing innovations in health care delivery. J Pediatr Health Care 1998;12(2):60–6.Google Scholar
  30. 30.
    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.Google Scholar
  31. 31.
    Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy Press, 2002.Google Scholar
  32. 32.
    Stoddard JJ, St Peter RF, Newacheck PW. Health insurance status and ambulatory care for children [see comments]. N Engl J Med 1994;330(20):1421–5.Google Scholar
  33. 33.
    Szilagyi PG, Zwanziger J, Rodewald LE, et al. Evaluation of a state health insurance program for low-income children: Implications for state child health insurance programs. Pediatrics 2000;105(2):363–71.Google Scholar
  34. 34.
    Kempe A, Beaty B, Englund BP, Roark RJ, Hester N, Steiner JF. Quality of care and use of the medical home in a state-funded capitated primary care plan for low-income children. Pediatrics 2000;105(5):1020–8.Google Scholar
  35. 35.
    Kasper JD. The importance of type of usual source of care for children’s physician access and expenditures. Med Care 1987;25(5):386–98.Google Scholar
  36. 36.
    Short PF, Lefkowitz DC. Encouraging preventive services for low-income children. The effect of expanding Medicaid. Med Care 1992;30(9):766–80.Google Scholar
  37. 37.
    Ford CA, Bearman PS, Moody J. Foregone health care among adolescents. JAMA 1999;282(23):2227–34.Google Scholar
  38. 38.
    Seid M, Sobo EJ, Zivkovic M, Nelson M, Davodi-Far M. Conceptual models of quality of care and health-related quality of life for vulnerable children. In: Sobo EJ, Kurtin PS, editors. Child Health Services Research: Applications, Innovation and Insights. San Francisco: Jossey-Bass, 2003.Google Scholar
  39. 39.
    Bindman AB, Grumbach K, Osmond D, Vranizan K, Stewart AL. Primary care and receipt of preventive services. J Gen Intern Med 1996;11(5):269–76.Google Scholar
  40. 40.
    Starfield B, Cassady C, Nanda J, Forrest CB, Berk R. Consumer experiences and provider perceptions of the quality of primary care: Implications for managed care. J Fam Pract 1998;46(3):216–26.Google Scholar
  41. 41.
    Aday LA. Designing and Conducting Health Surveys: A Comprehensive Guide. San Francisco: Jossey-Bass, 1989.Google Scholar
  42. 42.
    Nunnally JC, Bernstein IR. Psychometric Theory, 3rd ed. New York: McGraw-Hill, 1994.Google Scholar
  43. 43.
    Canales S, Ganz PA, Coscarelli CA. Translation and validation of a quality of life instrument for Hispanic American cancer patients: Methodological considerations. Qual Life Res 1995;4:3–11.Google Scholar
  44. 44.
    Hendricson WD, Russell IJ, Prihoda TJ, Jacobson JM, Rogan A, Bishop GD. An approach to developing a valid Spanish language translation of a health-status questionnaire. Med Care 1989;27(10):959–66.Google Scholar
  45. 45.
    Herdman M, Fox-Rushby J, Badia X. Equivalence and the translation and adaptation of health-related quality of life questionnaires. Qual Life Res 1997;6:237–47.Google Scholar
  46. 46.
    Keller SD, Ware JE, Jr., Gandek B, et al. Testing the equivalence of translations of widely used response choice labels: Results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998;51(11):933–44.Google Scholar
  47. 47.
    Ware JE, Keller SD, Grandek B, Brazier JE, Sullivan M. Evaluating translations of health status questionnaires: Methods from the IQOLA Project. Int J Technol Assess Health Care 1995;11:525–51.Google Scholar
  48. 48.
    Varni JW, Seid M, Rode CA. The PedsQL: Measurement model for the pediatric quality of life inventory. Med Care 1999;37(2):126–39.Google Scholar
  49. 49.
    Varni JW, Seid M, Kurtin PS. The PedsQL™ 4.0: Reliability and Validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in Healthy and Patient Populations. Med Care 2001;39(8):800–12.Google Scholar
  50. 50.
    Cohen J, Cohen P. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Hillsdale, NJ: Erlbaum, 1983.Google Scholar
  51. 51.
    Seid M, Castaneda D, Mize R, Zivkovic M, Varni J. Crossing the border health care: Access and primary care characteristics for young children of Latino farm workers along the U.S.-Mexico border. Ambulat Pediatr 2003;3(3):121–30.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  1. 1.RAND HealthSanta Monica
  2. 2.Department of Landscape Architecture and Urban Planning, College of Architecture, Department of Pediatrics, College of MedicineTexas A&M UniversityCollege Station
  3. 3.RAND CorporationSanta Monica

Personalised recommendations