Linking Primary Care to the Community: A Study of Pediatric Practices in Florida

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The broad domains of the qualitative interview included 1) initial feeling about transforming into a medical home, 2) internal factors that made them unique, 3) external factors that affected the practices, and 4) community linkages. We regard community linkages as connections to any person, group, or institution outside of the practice. Community was not explicitly defined for the practices but rather core practice teams were asked about their current connection to the healthcare system, traditional and special schools, and interactions with patients in community settings (such as health fairs). They were also asked to gauge their influence on the healthcare system and their community. The constant comparison method was used to analyze the data. Once themes and categories were established, emerging patterns were identified. Responses were coded using ATLAS.ti (version 7.0.85, 2013, GmbH, Berlin, Germany), a software program for analysis of qualitative data. Participant responses were assigned codes representing specific a priori themes identified in the interview guide. Additional codes representing emergent themes were also developed. Preceding formal coding using ATLAS.ti, two transcripts (10%) were hand-coded separately by three researchers in order to ensure inter-rater reliability (IRR). The IRR was calculated as 0.95 for both specific content coding and general theme coding.