507 - Our Life, Our Story: Amplifying Caregiver Voices to Promote Dignity in Pediatric Primary Care through Narrative Medicine and Large Language Model Analysis

Publication Number: 4498.507

Noah Smith, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Kristen A. Copeland, Cincinnati Children's, Cincinnati, OH, United States; Kathleen Bain, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Jane Driano, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Narrative competence, or the ability to absorb and respond to patient stories, can improve empathy, communication, and equity in healthcare. The VA’s “My Life, My Story” program, in which volunteers interview veterans about their life, compiling a 1000-word version for readback to the veteran and incorporating into the electronic health record, have shown benefits for patients and providers in adult care, but there is limited evidence for pediatric outpatient settings and underserved populations.

Objective: To adapt the “My Life, My Story” principles for a large outpatient pediatric primary care clinic (90% public-insured, 80% Black) and to identify barriers to child wellbeing, family strengths, and actionable themes for improved health equity. Hereout, referred to as "Our Life, Our Story" program.

Design/Methods: Four interviewers trained in “My Life, My Story” methods recruit at least 22 caregivers of clinic patients aged 0 to 5 years for 20 minute semi-structured interviews exploring familial strengths, caregivers’ family history, and social supports. Interviews are drafted into 500-word first-person narratives for caregiver’s review. The finalized stories undergo qualitative analysis using both large language model (LLM) assisted thematic coding (utilizing ChatGPT-5) and manual coding by authors to validate the analysis.

Results: Eight caregiver narratives were collected for preliminary analysis (with 10-15 additional anticipated by January). Using a 12-theme schema, four narratives (50%) were manually coded to validate LLM outputs. Agreement between manual and LLM-derived themes was substantial (83.3% raw agreement, κ = 0.63). Recurring themes included family and social support, healthcare navigation, and caregiver coping. Caregivers often highlighted resilience and connection: “My mom and grandma keep me going when it gets hard,” and “We lean on each other because sometimes that is all we have.” Narratives reflected strength amid exhaustion; “Even when I am tired, I try to stay patient because [my child] learns from me.” Others described ongoing barriers, including limited transportation and work schedules that interfered with appointments: “If the bus runs late, we miss the visit.”

Conclusion(s): Early implementation of “Our Life, Our Story” demonstrates that capturing caregiver narratives can be feasibly integrated into community-based pediatric care and meaningfully analyzed using LLM-assisted methods. Preliminary findings illuminate both resilience and barriers rooted in social determinants of health, offering actionable insights for clinicians and systems-level interventions.

Noah Smith - Letter of Good Standing at UC College of Medicine
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