226 - Defending the Health of Our Future: A Qualitative Study of Military Families' Experiences with Pediatric Care

Poster Number: 226
Publication Number: 226.1754

Background: The four million U.S. military-connected children under five years of age have unique healthcare challenges related to frequent moves, prolonged family separations, and living in remote and international settings. Prior quantitative analyses reveal significant healthcare disparities across rank, race, and branch of service. In addition to the known association between frequent moves and lack of healthcare continuity, previous studies have also demonstrated an association between deployments, increased stress, and mental health diagnoses in parents and young children.

Objective: Elucidate the challenges that military-beneficiary children and families encounter from their own perspective.

Design/Methods: This qualitative examination is part of an overarching study describing the birth experiences of U.S. military beneficiaries. From February to June 2023, 30 semi-structured interviews were conducted with military beneficiary participants who had a pregnancy event in the last five years. Questions focused on experiences surrounding the care of their most recent newborn. Inductive coding was utilized to identify themes related to both identity and potential etiology of challenges specific to early childhood healthcare within the Military Health System (MHS).

Results: Parents identified three predominant themes related to challenges in caring for their children in the MHS: (1) healthcare access issues, (2) breastfeeding support, and (3) childcare, Table 1. Regarding healthcare access issues, parents specifically described challenges with birth registration, referral logistics, appointment access, and care coordination. Generally, these were present in both military and civilian care settings but were most salient if care was delivered in the civilian sector. Challenges with breastfeeding support included access to lactation consultants and time to pump at work. Finally, despite most military installations offering childcare services, many parents described difficulty accessing these services.

Conclusion(s): Despite universal employment and insurance coverage, military families face unique challenges. Military-specific challenges include those related to remote locations with limited resources and difficulty navigating the military insurance network. Families also describe issues well documented for civilian parents, including suboptimal lactation support, logistical challenges upon return to work, and childcare. As more military-connected families receive care in the civilian sector, pediatric providers must be aware of these challenges.