Trust, Advocacy, Inequity, and Information: A Qualitative Study of PICU Communication Experiences Among Low-Income Families in the United States

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Among low-income families in the PICU, trust in the healthcare team is shaped by medical and socioemotional behaviors, the inclusion of parental perspectives, experiences with discrimination, and diverse information-seeking preferences. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Emily Kemper; Michelle N. Eakin; Jinnesse Taylor; Sapna R. Kudchadkar

doi:10.1097/pcc.0000000000004053

September 11, 2026Pediatric Critical Care Medicine

Trust, Advocacy, Inequity, and Information: A Qualitative Study of PICU Communication Experiences Among Low-Income Families in the United States

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Key Points

To characterize the communication experiences, challenges, and trust-building factors among historically marginalized and low-income families in the pediatric intensive care unit (PICU).
Conducted semi-structured qualitative interviews between October 2023 and April 2025 at a single tertiary-care academic PICU in the United States.
Included 22 family members (13 mothers, 7 fathers, 2 grandparents) across 17 families whose children had income-based Medicaid and were admitted for at least 5 days.
Audio-recorded, transcribed verbatim, and analyzed interview transcripts using a constant comparative coding method.
Identified four core themes: clinician behaviors affecting trust, the role of parental advocacy and valuing parent perspectives, the intersection of race with healthcare experiences, and varied information-seeking preferences.
Family trust depended on both medical competency and socioemotional behaviors, with trust bolstered when clinicians validated parents as experts on their child and degraded by perceived discrimination.
Families relied on multidisciplinary ICU rounds for updates but also frequently consulted diverse external sources to address communication gaps.

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Implication

Qualitative interview study reveals how clinical communication and discrimination shape trust among low-income families in the PICU, highlighting key targets for equitable family engagement.

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Kemper et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b3060926e14a848b1ad4 https://doi.org/10.1097/pcc.0000000000004053

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Trust, Advocacy, Inequity, and Information: A Qualitative Study of PICU Communication Experiences Among Low-Income Families in the United States

Key Points

No abstract yet

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Implication

Discussion

Cite This Study

Trust, Advocacy, Inequity, and Information: A Qualitative Study of PICU Communication Experiences Among Low-Income Families in the United States

Key Points

No abstract yet

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Implication

Discussion

Cite This Study

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