“I was very scared when I found out my son had sickle cell”: Caregiver knowledge and attitudes toward early intervention for young children with sickle cell disease: Implications for policy and practice from a multi‐site study
Program in Occupational Therapy, Washington University School of Medicine
How they used Delve
Researchers at Washington University School of Medicine and St. Jude Children's Research Hospital used Delve to pilot and apply a 10-code, 17-subcode codebook across 20 caregiver interviews about early intervention for young children with sickle cell disease, checking every transcript for coder agreement before building themes.
“The codebook was piloted with four interviews to ensure consistency across coders using DelveTool Software.27 All transcripts were reviewed for agreement, and discrepancies were cleared through discussion.”
- Field
- Pediatric hematology / occupational therapy and early intervention
- Data
- Caregivers of children aged 0-4 with sickle cell disease at two US sites: 127 approached, 47 completed surveys (Caregivers Perceptions Survey and Knowledge of Infant Development Inventory via REDCap) and 20 completed qualitative interviews
- Approach
- Qualitative descriptive analysis alongside survey data: a codebook of 10 codes and 17 subcodes structured on the interview guide was piloted across four interviews for coder consistency, all transcripts checked for agreement with discrepancies resolved by discussion, then codes analyzed for patterns and conceptual linkages into themes; reported against COREQ
- Data types
- Interviews, Open-ended survey responses
Abstract
OBJECTIVE: This study characterized caregivers’ beliefs related to early intervention services for children with sickle cell disease (SCD) to gain an indepth understanding of caregivers’ experiences and desires for early intervention services. METHODS: Both qualitative and quantitative data were collected from caregivers of children aged 0-4 years with SCD across two sites in the United States. Caregivers completed the Knowledge of Infant Development Inventory, a custom survey about their experiences with early intervention, and a qualitative interview. RESULTS: A total of 127 caregivers were approached, 47 participated in surveys, and 20 completed interviews. Caregivers expressed varying levels of confidence and understanding of developmental milestones across sites. Interviews highlighted three main themes: fear of SCD-related complications, variable buy-in to early intervention, and the importance of provider-caregiver relationships. While some caregivers appreciated early intervention, others questioned its necessity. Caregivers communicated interest in connecting with other families facing similar challenges, emphasizing the need for increased awareness of available resources. CONCLUSIONS: Fear about their child’s well-being was expressed by many caregivers, emphasizing the need for a supportive healthcare team that can help families connect with preventive interventions. While about a quarter of children had been referred to rehabilitation services, caregivers were unaware of the elevated risk for developmental delay, which diminished caregiver interest in participating in programs like early intervention. This study underscores the importance of addressing knowledge gaps and overcoming barriers to enhance care for families affected by SCD.
Citation
Catherine R. Hoyt, Erin MacArthur, H. Leaver, Ashley L. Wilson, Kandace Davis, Kelly M. Harris, Riley Damiano, Hunter Moore, Ashley J. Housten, Rosemary Britts, Jane S. Hankins, Allison A. King, Andrew M. Heitzer (2024). “I was very scared when I found out my son had sickle cell”: Caregiver knowledge and attitudes toward early intervention for young children with sickle cell disease: Implications for policy and practice from a multi‐site study. Pediatric Blood & Cancer. https://doi.org/10.1002/pbc.31308