494 - Adapting an Online-Based, Family-Centered, Peer Navigator Intervention to Facilitate Cross-Sector Systems Navigation for Low-Income, Spanish-speaking Caregivers of Children with Medical Complexity

Publication Number: 1474.494

Jennifer B. Peralta, UCLA, Los Angeles, CA, United States; Flor Arellano, UCLA Health, Los Angeles, CA, United States

Background: Children with medical complexity (CMC), a subset of children and youth with special health care needs, face unique systemic barriers and care coordination challenges that span the healthcare, education, and social services systems. CMC caregivers experience tremendous burdens as they access and navigate these complex, highly fragmented systems of care leading to unmet care coordination needs, decreased family functioning and poor health outcomes. New initiatives to address these challenges leverage the effectiveness of peer support programs with technological advances (Undivided™). Unfortunately, these interventions often fail to meet the needs of CMC caregivers from diverse and minoritized populations, particularly those from low-income, immigrant or limited English-proficient (LEP) backgrounds.

Objective: To understand the perspectives and lived experiences of CMC caregivers and peer navigators to inform an adaptation of Undivided™, an online-based, care coordination, and peer navigator program, to meet the needs of low-income, Spanish-speaking caregivers of CMC, especially those with lower levels of digital proficiency.

Design/Methods: To date, semi-structured focus group and 1:1 interviews have been conducted with key stakeholders including 14 CMC caregivers currently enrolled in Undivided™, 10 Undivided peer navigators, and 6 Spanish-speaking CMC caregivers enrolled in a pediatric complex care program. Interviews are audio recorded and transcribed. Transcript review and independent coding is performed followed by discussion of initial codes using a Constructivist Grounded Theory approach. Codes will be refined through iterative analysis until thematic saturation is reached.

Results: Emerging themes include: 1) Providing proactive, intentional supports for all users (e.g. technology training, scaffolded tools, accessible interfaces) to support caregivers with varying levels of digital literacy and preferred language needs; 2) Importance of text/phone-based access points to promote digital equity; 3) Importance of human connection within technology-based platforms; 4) Respecting the lived experience and concerns (e.g. data security) specific to those from historically marginalized groups.

Conclusion(s): Digitally based care coordination platforms present a unique point of access to care coordination support for low-income, Spanish-speaking CMC caregivers. Applying a digital equity-centered approach to the development and adaptation of technology-based programs is imperative to ensure accessibility and usability for this population and other populations at risk for digital exclusion.

Table 1. Themes and Selected Illustrative Quotations
2026 PAS abstract_Table 1_JenniferPeralta.pdfTable 1. Themes and Selected Illustrative Quotations