Health Care for Hawaiian Foster Children

Abstract

Foster children represent a vulnerable pediatric population with complex health needs including both acute and chronic conditions that require comprehensive health care management. However, years of research has continually demonstrated a poor provision of health care services to this at risk population including gaps in preventative care and poor follow-up with specialty services. Current literature reveals that the health care management for foster children continues to be fragmented and subpar. Several health care delivery models, standards of care, and interventions have been recommended in an effort to improve the outcomes among foster children. However the perspective of foster parents, key caregivers, has been missing in current evidence. This investigation serves as a descriptive study utilizing grounded theory methodology to explore health care management from the Hawaii foster parent's perspective. The purpose of the investigation was two-fold: 1) to describe foster parents' experience obtaining health care for their foster children and 2) to elicit foster parents' opinions about whether or not a health education program designed for foster parents would be helpful. After completing seven individual interviews, which were analyzed using constant comparative analysis, 19 categories were developed describing the foster parent experience related to policy and services, social environment, physical environment, biology, and behavior. The concept of a medical home model was identified as unfeasible for Hawaii foster families, and large variations in health education preparation among foster parents was observed while a significant interest in further education on health-related topics was identified as a necessity. Implications for practice and recommendations for further research were also generated.