CORE Posters Fall 2025

Barriers and Facilitators to the Utilization of Community-Based Preventive Care Services for Children Among Low-Income Mothers in Southwest Virginia: A Cross-Sectional Study

Barnett, E., Blackshear, A., Boesler, J., Boling, J., Brown, M., Jeizan, P., Vuthuri L., Zarzar M., Kelly, S., Nicholson, J. MAT, & Kadio B. MD, PhD. ​ Edward Via College of Osteopathic Medicine, Preventive Medicine, Blacksburg, Virginia.

Group H

Results

Abstract

Conclusion

• The Child’s Health Improvement Partnership (CHIP) delivers essential home visits and supportive services to low-income families. • Giles County, Virginia still experiences elevated rates of child mortality, poverty, and adverse maternal-child outcomes, suggesting underutilization of CHIP services. o This study seeks to identify barriers to CHIP utilization and evaluate strategies to improve enrollment.

Key Findings • Barriers are multifactorial, overlapping, and not explained by single factors. • Emotional barriers (stress, fear, stigma) showed the most variability and may strongly deter service use. • Current sample skews toward white, insured families, likely underrepresenting challenges faced by uninsured and minority groups. Implications • Need for holistic, multi-level interventions. • Tailored outreach for uninsured and diverse populations. Next Steps • Phase 2: Design and pilot evidence-based interventions using literature, Phase 1 findings, and local needs. • Phase 3: Scale successful interventions community-wide and assess impact. References 1. Wild CEK, O’Sullivan NA, Lee AC, et al. Survey of Barriers and Facilitators to Engagement in a Multidisciplinary Healthy Lifestyles Program for Children. Journal of Nutrition Education and Behavior. 2020;52(5):528-534. doi:10.1016/J.JNEB.2019.10.010 2. Medavarapu H. Sycamore Scholars Sycamore Scholars Electronic Theses and Dissertations College Students’ Perceptions of Barriers to Seeking Health Care College Students’ Perceptions of Barriers to Seeking Health Care.; 2014. 3. Pourat N, Lu C, Chen X, et al. Trends in access to care among rural patients served at HRSA-funded health centers. J Rural Health. 2022;38(4):970-979. doi:10.1111/jrh.12626 4. Bureau USC. U.S. Census Bureau QuickFacts: Giles County, Virginia. Published 2025. 5. Bensken WP, Dankovchik J, Fein HL, Duhon G, Sills MR. Unwinding of Continuous Medicaid Coverage Among Pediatric Community Health Center Patients. JAMA Netw Open. 2025;8(2):e2458155. doi:10.1001/jamanetworkopen.2024.58155

• Guided by the Health Belief Model and the Theory of Planned Behavior, we hypothesize that limited awareness,

misconceptions regarding eligibility, and complex enrollment processes represent primary barriers.

Figure 1. Comparison of Average Survey Responses by Respondent's Perceived Barriers by Category. Box and whisker plots displaying the distribution of scores across five categories — Emotional, Structural, Autonomy, Stigma, and Overall Barrier Score. The mean scores are indicated by the X, showing central tendency, while whiskers represent variability and potential outliers in the data. • All barriers played a role in the accessibility of CHIP; however, the impact varied among age, insurance status, and ethnicity • Emotional barriers has the most impact on participants older then 65, are uninsured, and African American • Stigma has the least impact on participants between 55 and 64 years old, are uninsured, and Asian

• Interventions such as enhanced education, community outreach, and enrollment support are anticipated to increase CHIP utilization and improve maternal-child health outcomes in Giles County.

Methods

Data Collection

Recruitment

Survey Distribution

• Recruitment : CHIP-enrolled families (pregnant individuals and individuals with children ages 0-4 meeting Medicaid or income-based criteria). • Surveys : administered to families to assess awareness, accessibility, and barriers to enrollment. • Data collection : focused on utilization patterns and community factors influencing participation.

Thank you to the Children’s Health Improvement Partnership (CHIP) of the New River Community Action for their partnership throughout this project.

Figure 2. Correlation plot of Perceived Barrier Category in relation to their likelihood to seek help

VCOM IRB #2025-057; Approval Date 8/28/2025