P3.P308: Parent Perspectives on Civic Engagement Promotion in Healthcare Settings

Background: Increased civic engagement has been shown to be associated with improved child health outcomes at the population level. Voter engagement has been hypothesized as a strategy for achieving health equity, and voter engagement in healthcare spaces has been shown to be feasible and effective. The mechanism underlying the association between voting and health remains unclear. This qualitative study explores, via semi-structured interviews, parent perspectives on 1) the connection between voting and child health; and 2) the best ways for clinicians to promote civic engagement among patients and their families.

Methods: Parents or guardians of all patients seen at the 3 academic pediatric primary care offices at a large, urban children’s hospital in the Midwest were invited to participate by email. Interested and eligible participants completed a virtual in-depth interview with authors MJ or TD and an online demographic and voting habits survey. Interviews lasted 30-60 minutes and were transcribed verbatim. Trained coders independently analyzed transcripts using iterative, thematic, inductive open coding. Interviews continued until thematic saturation in the analysis was reached.

Results: In total, we conducted 22 interviews. Most participants self-identified as female (91%), Black (55%), and non-Hispanic (95%). Participants represented a variety of education levels, political perspectives, and degrees of civic participation (Table 1). Participant perspectives on the connection between voting and child health included: 1) voting helps “make your community a better place” for children now and in the future; 2) voting impacts funding for services (e.g., healthcare, public benefits, schools, public safety programs, etc.), which impact child health; and 3) voting impacts our social environment, which impacts child mental health (e.g., community connection, children feeling safe, public leaders serving as role models, etc.). Recommendations for civic engagement promotion in healthcare included: 1) consider context about voting messaging (e.g., ask patient permission before having voting discussions, provide context about connection with health); 2) provide a variety of communication media options for delivering voting information; and 3) include a variety of healthcare staff in delivering voting messages. Table 2 contains illustrative quotations corresponding to each theme.

Conclusion: In this qualitative study, we captured parent perspectives on the connection between voting and child health and effective methods to promote civic engagement in healthcare settings. Themes generated from this study can serve as hypotheses for future assessments of the mechanisms underlying established connections between voting and child health outcomes. Future work can also further study the role that clinicians play in closing health equity gaps through voter engagement.