"In the clinic they know us": Preferences for clinic-based financial and employment services in urban pediatric primary care

Objective: To understand views of adolescent and adult caregivers on integrating employment and financial services into a pediatric primary care clinic serving low-income families.

Methods: Eighteen in-depth qualitative interviews were conducted among caregivers of pediatric patients. Participants were recruited from those who completed a survey assessing financial and employment needs. Audio-recorded transcripts were analyzed using line-by-line coding of emerging themes.

Results: Adolescent and adult caregivers expressed difficulty managing financial stress. They cited having a criminal history, limited financial literacy, and lack of available quality jobs as barriers to achieving financial stability. A clinic-based employment and financial program was highly acceptable among potential users for the convenience it offers and the established trust and understanding between patients and clinical providers. Participants preferred one-on-one counseling for sensitive employment and financial issues, though they did believe that some topics, like building a resume, could be accomplished in group workshops.

Conclusions: Caregivers attending a pediatric clinic expressed interest in and anticipated value from clinic-based employment and financial services, if implemented services are relevant, accessible, and provide options for group and individualized approaches.