Multi-Dimensional Space Configurations for Social Pediatrics Health Care Delivery

Abstract

Introduction/Objectives: Health inequities among children remain problematic despite a global focus on health transformation. Adverse social and material conditions continue to make children vulnerable, resulting in health and developmental problems. Social Pediatrics is a socially driven approach to health care delivery designed to mitigate social and structural barriers to care for vulnerable children while considering the child's social context and ecosystem. The Centre de Pédiatrie Sociale du Vieux-Hull (CPSVH) is an empirical social pediatrics centre that addresses the social determinants of health. It is an operationalization of the social pediatrics model of providing culturally sensitive and comprehensive health care to the children and youth of Vieux-Hull, and support to their families, with the engagement of community partners. This study examined the multi-dimensional physical, social and collaborative space configurations at the CPSVH from the child's perspective, and the extent to which the spaces were socially supportive. The theories of Lefebvre's Production of Space and Complex Adaptive Systems were combined to inform our understanding of the space configurations and their attributed meaning. Methods: This exploratory study used a qualitative approach. Children were recruited purposively to participate. Data collection included focus groups, interviews and observation. Pictures of the CPSVH spaces were used during the focus groups. Direct observation informed my understanding of the child's social and physical interactions in the CPSVH spaces. Focus groups and interviews with health professionals and parents were conducted to complement the child focus group data. All the data sources were coded using NVivo 12. Directed content analysis was used to analyze the focus group, interview and observation data to identify emergent themes. Results/Conclusion: This study provided an understanding of how children interact with the multi-dimensional space configurations at the CPSVH, and the extent to which the unique design was socially supportive from the child's perspective. Twenty (n=20) children 7-13 years old, along with health professionals (n=6) and parents (n=7), participated in this study. Direct observation totalling 63.5 hours was also conducted. The Social Space Model of Health Care Delivery provides an empirical understanding of the space configurations and the interactions between the spaces. The model depicts the interactions between the structures, behaviours and social support, while considering the role of the social space. The model also provides language and terminology for modelling and understanding space configurations and social space patterns in complex health care delivery contexts. This understanding can help us design space configurations and the interconnectedness across spaces to enable tailored socially supportive patient-centred care.