Clinician and Care Manager Perspectives on Addressing Chronic School Absenteeism in Primary Care Settings.

OBJECTIVES: To characterize primary care clinician and care manager perceptions and practice regarding chronic absenteeism. METHODS: In this qualitative study, we developed a semistructured interview guide using the Consolidated Framework for Implementation Research. We conducted Zoom interviews (July to August 2023) with primary care clinicians and care managers affiliated with a child-focused alternative payment model serving Medicaid- and Children's Health Insurance Program-enrolled children in a 5-county region of central North Carolina. Interviews were recorded, transcribed, and analyzed iteratively using a rapid qualitative analytic approach. RESULTS: We interviewed 12 participants including 6 clinicians and 6 care managers serving families across urban, rural, academic, and community settings. Key themes included a lack of systematic and universal approaches to discussing school attendance, limited infrastructure for school-health system collaboration resulting in caregiver burden, importance of family engagement, and leveraging unique spheres of influence for multidisciplinary collaboration. CONCLUSIONS: Clinicians and care managers support addressing chronic absenteeism but perceive provider, patient, and system-level barriers to identifying and addressing underlying needs. Perceived facilitators include leveraging strong relationships with families and multidisciplinary collaboration. Health system efforts to operationalize chronic absenteeism as a health metric and to coordinate services across health, education, and social sectors may improve long-term health and academic outcomes.

Duke Scholars

Author Rushina Cholera Pediatrics, General Pediatrics and Adolescent Health