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Shepherd-Banigan, Choi, Shapiro, Van Loon, Kappler, Quiroz, Matthews, Garber-Cardwell, Morrison, King, Goldstein. Provider Perspectives on the Need for Child Care Assistance During Veteran Health Care Appointments. Journal of general internal medicine. 2025 Apr 23 DOI: 10.1007/s11606-025-09517-3.
Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects. BACKGROUND: Lack of child care is a primary cause of delayed care in the United States for individuals caring for children, including Veterans. Given the substantial barriers to child care, children frequently accompany their guardians to health care appointments. Data from patients suggests that the presence of children can be distracting for the patient, but literature exploring the perspectives of providers is scant. OBJECTIVE: To examine provider perspectives on how the presence of children during health care visits impacts the care experience for both providers and Veterans, with the goal of informing future child care assistance programs. DESIGN: Qualitative study design. PARTICIPANTS: The study participants included a national convenience sample of 10 cross-specialty clinicians who provide care for Veterans within the Veteran Health Administration (VHA) health care system. APPROACH: We conducted semi-structured interviews delivered over the telephone. Interview topics explored clinician experiences with children during Veteran health care visits on quality of care, access to care, ability to discuss sensitive topics or perform sensitive exams, and patient-provider communication. KEY RESULTS: Providers describe how inadequate child care impedes Veteran''s access to health care. Furthermore, providers reported that the presence of children during Veteran health care visits decreases the quality of care, negatively impacts patient-provider communication, and increases the burden on other patients and medical staff. For example, providers reported that the presence of children in the exam may reduce the Veteran''s and provider''s willingness to discuss sensitive topics and perform sensitive procedures, which can lead to delayed care and impede patient-provider relationship building. CONCLUSIONS: Given the negative consequences of inadequate child care during medical appointments, health care systems can and should explore programs, such as providing child care assistance to patients. While this practice is not widespread, several health systems, including the VHA, are implementing such programs.
