Caregiver Health Beliefs Associated with Use of Pediatric Therapy Services Among Children with Special Health Care Needs

Objectives (1) Explore the relationship between various sociodemographic factors and caregiver health beliefs (CHBs), and (2) examine whether these relationships were associated with the use of pediatric therapy services. Methods We conducted a cross-sectional, secondary data analysis using the 2011 Survey of Pathways Diagnosis and Services dataset. 4,032 children ages 6-17 years had complete data on caregiver health beliefs and pediatric therapy use. Select CHBs reflected whether caregivers believe (1) problems related to their child's condition can be prevented or decreased with treatment, (2) they have the power to change their child's condition, and (3) their child's condition is a mystery. Pediatric therapy included physical therapy, occupational therapy, and speech therapy. We performed multivariate logistic regression to test the associations between CHBs and select child and family characteristics (Aim 1) and use of pediatric therapy services (Aim 2). Results Caregivers with lower educational attainment were more likely to believe their child's condition was a mystery and less likely to believe they had the power to change their child's condition. Use of pediatric therapy services tended to be lower among children whose caregivers believed they had the power to change their child's condition and higher among children whose caregivers believed their child's condition was a mystery. Conclusions for practice Our findings add to existing research that suggests CHBs differ across groups of caregivers. This, combined with the recognition that CHBs also likely differ from providers, underscores the importance of eliciting caregiver beliefs, values, and priorities to help ensure the provision of truly family-centered care. Significance Pediatric therapy services support and optimize child development. Significant service use disparities exist, however, with children representing various marginalized groups being less likely to use pediatric therapy services. Little is known about the mechanisms underlying such disparities. We sought to explore the relationship between family sociodemographic factors, caregiver health beliefs, and pediatric therapy use. Our findings suggest that caregivers with fewer socioeconomic resources expressed beliefs that are consistent with limited knowledge and agency regarding their child's condition. Thus, providers must work to engage families in conversations about their child's development, elicit their knowledge and beliefs, and identify social or financial barriers to care.