Improve health disparities with trust, partnership

Kara Koschmann, PhD, APRN, CPNP-PC, has a message for health care providers who want to improve health disparities for children: trust and partnership with parents are key. Koschmann, who recently completed a dissertation under the advisement of Center for Children with Special Health Care Needs faculty member Casey Hooke, PhD, APRN, PCNS-BC, CPON, FAAN, conducted focus groups with urban, low income African American parents of young children. While the focus was on well child care for healthy children, she discovered that many of the parents in her focus groups also had a child with a chronic condition at home.

“We know that African American children are more likely to have a chronic condition such as asthma, and we’re trained to evaluate this risk; yet it’s racism, not race, that accounts for these differences,” says Koschmann, who is an assistant professor at St. Catherine University.

She says that trust is essential to addressing these disparities. “Trust is easily broken because of a history of systematic disadvantages and biased assumptions,” she says. According to Koschmann, parents sought advice from relatives and friends before their pediatric provider. They shared numerous examples of broken trust and misunderstandings with their child’s provider.

The parents in her study were eager to give voice to the community. Koschmann found that if she stood outside grocery stores or spent time in the neighborhoods where the families she wanted to hear from lived, word spread quickly that there was someone ready to listen. “They brought friends and other parents,” says Koschmann. Parents had three key messages for providers who want to build trust and partnership with parents from historically marginalized groups: “Take time to get to know me and my child, show me through your actions that you care, and listen to me”. Results of Koschmann’s research are in press in the Journal of Pediatric Nursing, and her co-authored paper, ‘I Can’t Breathe’: A Call for Antiracist Nursing Practice was recently published in Nursing Outlook.