WIP 109 - Qualitative Exploration of Neighborhood-Level Disparities in Pediatric Trauma

Poster Number: WIP 109
Publication Number: WIP 109.914

Background: Unintentional traumatic injuries are the leading cause of death in children ages 1-14. Studies demonstrate greater injury severity and differential injury mechanisms in children from more socioeconomically disadvantaged areas. However, there is scant existing qualitative research exploring neighborhood-level risk factors and inequities contributing to pediatric trauma from the perspective of those affected.

Objective: To use the socioecological framework for evaluation of specific neighborhood and community level risk factors for pediatric trauma. We hypothesized that we would reach thematic saturation across each socio-ecological domain.

Design/Methods: This study was designed as a phenomenological qualitative study using semi-structured, long-form interviews with a convenience sample of English- and Spanish-speaking caregivers of children ages 2-14 admitted to an ACS Level 1 pediatric trauma center following a traumatic injury. Caregivers of children with injuries involving deaths, significant functional impairment, or Child Protective Services involvement were not eligible for enrollment. Following approval by the IRB, recruitment was initiated and continues on a rolling basis. Recruitment is stratified to enroll a representative sample across Area Deprivation Index (ADI) quintiles. Interviews are recorded via Zoom or phone, and transcriptions are entered into Atlas.ti for thematic analysis. The primary outcome measures are the key themes and domains related to the individual, family, neighborhood, institutional, and state levels identified from interviewees’ perceptions of risk factors and disparities leading to their child’s traumatic injury. We are collecting demographic data and ADI associated with the caregiver’s residence at the time of enrollment. To date, 5 interviews have been completed. Recruitment, interviews, and analysis will continue until thematic saturation is reached, estimated at approximately 20 interviews based on previous similar work. At our current pace of enrollment, we plan to complete enrollment and thematic analysis by March 2024.