The path to partnership: Improving family engagement strategies in the North Carolina integrated care for kids model

OBJECTIVE: Pediatric care management has the potential to streamline care delivery across fragmented child-serving sectors, but successfully engaging families is challenging. This study aimed to understand barriers and facilitators to family engagement from the perspectives of care managers in a pediatric integrated service delivery model for children with health and social needs. 

METHODS: Three virtual focus groups were conducted with care managers from North Carolina Integrated Care for Kids (NC InCK), a federal demonstration model to integrate cross-sector care for Medicaid-enrolled children under twenty-one years. The focus group questions were developed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Rapid qualitative analysis methods were used for analysis. 

RESULTS: Eleven care managers were included across three focus groups. Four themes emerged: 1) Rapport Building Strategies; 2) Simplifying Program Detail and Providing Information One Step at a Time; 3) Firewalls - Barriers in Technology and Information; and 4) Retention: One and Done. Care managers identified several barriers to engaging families, including effectively communicating the program's benefits, building trust via cold-calls, and facilitating long-term retention beyond an initial encounter. They revealed that rapport-building strategies could enhance family engagement by providing tangible resources early in the engagement and offering basic needs assistance to support the whole family, such as rent assistance. 

CONCLUSION: This study illuminated barriers and facilitators to the family engagement process through the lens of care managers. Our findings support evidence to inform family engagement strategies for children with multi-sector needs, filling a gap in the pediatric care management literature.