Barriers and Facilitators to Health Care Integration With Child Welfare: A Qualitative Assessment

OBJECTIVE To evaluate the current state of health care integration within the Safe Babies Court Program (SBCP) and identify barriers and facilitators from the perspectives of families and professionals in the judicial and child welfare systems. METHODS We conducted 21 qualitative interviews with families and professionals engaged with the SBCP, using discovery and action dialogues adapted for individual conversations. We applied the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, focusing on the “Exploration” stage. We conducted 2 phases of qualitative analysis: content analysis followed by rapid qualitative analysis informed by the EPIS framework. Through this 2-phase analytic approach, we combined our understanding of the context within which SBCP works with the identification of specific barriers and facilitators to integration of the health care system. RESULTS Barriers to health care integration include intergenerational Department of Human Services involvement, social determinants of health, lack of communication, trust, collaboration across systems, families not clearly understanding their rights, lack of time and resources, and sustainability. Facilitators include relationship building across systems, specific programs designed to work collaboratively across sectors, and specific individuals with compassion and knowledge of the system and resources. CONCLUSION Factors identified by families and professionals involved with the SBCP will inform interventions to help facilitate health care integration, communication, and cross-sector collaboration for families involved with child welfare.