Evaluating Perception of Child Health and Safety Needs in a Community Through the Perspective of Caregivers and Physicians

Zheyi N/A Teoh, Ashley Zerr, Allison Black, Kerry Caperell, Wayne Rice, Brit Anderson


Objective: To identify and compare child health and safety concerns in the community from the perspective of physicians and caregivers in Louisville.

Design: We administered surveys to physicians and caregivers who were asked to list, via open-ended questions, the top three health or safety concerns they had for children in three separate age groups (≤ 3, 4-11, and ≥12 years old). Four reviewers assigned responses to a pre-specified category/subcategory through a schematic designed by the study team and a fifth reviewer addressed any discrepancies and assigned final categories. Agreement in assigning overall categories was measured using Fleiss Kappa and descriptive statistics were used to characterize the responses.

Setting: Surveys were administered to caregivers who attended community events in Park Duvalle, a lower socioeconomic neighborhood in Louisville whose residents are predominantly black. Surveys were simultaneously administered to physicians throughout the University of Louisville/Norton Healthcare system.

Participants: A total of 41 caregivers with at least one child and 43 physicians were surveyed in this study.

Results: Overall categorical agreement between reviewers was k = 0.839, indicating good agreement on assignment. Injury/violence was identified by both caregivers and physicians as the top concern for children across all age groups. Wide variation was found when analyzing specific injury/violence subcategories, with caregivers more worried about household safety (17-40%) and gangs/unsafe neighborhoods (10-50%) while physicians were more concerned about sleep safety (36%), domestic violence (8-27%), and unintentional injury (10-20%).

Conclusions: Survey administration was a feasible method of comparing health and safety concerns among caregivers and physicians. We identified injury/violence as the top health and safety concern across all age groups in our community but noted variation on the specific type of injury/violence. Replication of our study methodology in other neighborhoods may allow for improved comparison of caregiver and physician concerns.


Community Health, Injury and Violence

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Assessing & Addressing Community Health Needs. Washington, DC: Catholic Health Association of the United States; 2013.

Preston J. Community Assessment Tools: A Companion Piece to ‘Communities in Action: A Guide to Effective Projects. Available from: https://www.clubrunner.ca/Data/5890//HTML/87938//Community%20Assessment%20Tools.pdf.

Community Health Needs Assessment FY 2017-192019. Available from: https://uoflhospital.org/sites/default/files/2017-12/Updated%20FY17-19%20ULH%20CHNA.pdf.

Community Health Needs Assessment 20192019. Available from: https://nortonhealthcare.com/wp-content/uploads/2019-community-health-chna-report.pdf.

David Gray CK, Chuck Anderson, Matt McDonald, Karen Newman, Nathan Wilson, Randall Caldwell, Gayle Dickerson, Susan Arnold, Julie Harrison, Ronda Merryman-Valiyi, Alexander Kerns, Anne Sydnor. Community Health Needs Assessment 20182018. Available from: https://issuu.com/baptisthealthkentucky/docs/final-_bhlou_august_2018_community_?e=14411368/64146

Abuosi AA. Patients versus healthcare providers' perceptions of quality of care. Establishing the gaps for policy action. Clinical Governance: An International Journal. 2015;20(4):170-82. 6. 279.

Patrick Smith MP, Lisa Crabtree, Robert Illback. Louisville Metro Health Equity Report: The Social Determinants of Health in Louisville Metro Neighborhoods.2011. Available from: https://louisvilleky.gov/sites/default/files/health_and_wellness/che/health_equity_report/her_final_jan23.pdf

Equity CfH. 2017 Health Equity Report: Uncovering the Root Causes of Health. Louisville Metro

Department of Public Health and Wellness2017. Available from: https://louisvilleky.gov/government/center-health-equity/health-equity-report

Heron M. Deaths: Leading Causes for 2017. National Vital Statistics Reports. Hyattsville, MD2019.

Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents,. 4th ed. Joseph F. Hagan J, Judith S. Shaw, Paula M. Duncan, editor. Elk Grove Village, IL: American Academy of Pediatrics; 2017.

Morrongiello BA, Hillier L, Bass M. 'What I said' versus 'what you heard': a comparison of physicians' and parents' reporting of anticipatory guidance on child safety issues. Inj Prev. 1995;1(4):223-7.


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