Addressing a Fear of Family Separation Among a Hispanic Pediatric Population

Purpose: The purpose of the project was to develop and disseminate a culturally relevant resource toolkit to primary care pediatric providers delivering care to immigrant populations. The aim was to equip providers to support Hispanic families facing increased stressors related to family separation in the face of current immigration policies. Problem: Approximately six million children under the age of 18 in the United States are living with one or more undocumented family member. The American Academy of Pediatrics recognizes that the threat of family separation due to detention and deportation is a stressor. Prolonged stressors can affect the architecture of the developing child's brain and reduce healthy neural connections resulting in poor emotional and physical development. In Salt Lake City, primary care pediatric providers working with immigrant families recognized the need for more training and local resources to better address the looming threat of family separation that Hispanic children and their families may face. Methods: This quality improvement project included two components. The first involved the gathering of culturally relevant materials to create a toolkit of resources for providers caring for Hispanic families. The second was the introduction of the toolkit to primary care pediatric providers through an educational thirty-minute PowerPoint presentation. Essential components of the toolkit included lists of family and community support resources, local legal and mental health resources translated into Spanish, examples of emergency care plans for families, an introduction of resiliency training and stress coping skills, and validated mental health screeners for depression and anxiety. The educational presentation included key statistics regarding immigrant populations, current information on immigration policies and family separation, and pertinent research findings on prolonged stressors and their impact on children. Results: Forty-six participants including pediatric resident and supervising physicians, medical students, clinical office staff, and key members of the care coordination team (medical assistants, nurses and Spanish-language interpreters) attended the educational presentation. Forty-five participants completed a pre- and post-educational survey. Results showed participants had an increase in confidence after the educational presentation in offering services and resources to patients related to the fear of family separation and immigration issues. Results from a survey completed by attendees one month later showed that 70% of attendees from the first educational presentation were able to use the resources of the toolkit in their clinical practice. Conclusions: This project demonstrated that primary care pediatric providers who care for immigrant populations benefitted from an educational presentation focused on the issue. Participants reported that the introduction of community resources available to help immigrant families was most useful. We concluded that by educating pediatric providers to be aware of the challenges that immigrant families experience related to immigration policies and better equip them to offer patient resources, there is an opportunity to mitigate the long-term effects of continuous stressors and promote health downstream.