Service-Related Barriers and Facilitators in an Early Childhood System of Care: Comparing the Perspectives of Parents and Providers


Systems of care (SOCs) have the potential to enhance underserved families’ access to integrated health and support services. Most scholarship on SOCs has involved school-aged children and adolescents. Thus, research is needed to better understand barriers to, and facilitators of, families’ access to services during early childhood. The present study included a community-based participatory approach in understanding services for families of children under age six years with severe emotional and behavioral problems. We analyzed data from two focus groups with caregivers (n = 7) and three focus groups with service providers (n = 22). Our thematic analysis of participants’ responses revealed five primary barriers to family service access, including challenges associated with transition planning. In comparison, participants described four primary facilitators of family service access, including providers’ adoption of “whole-family” service delivery approaches. Findings indicated areas of convergence and divergence in caregivers’ and providers’ responses. We discuss limitations and potential implications.

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The preparation of this paper was supported, in part, by the first author’s National Institutes of Health T32-funded postdoctoral training fellowship (T32DA019426-11) and with additional support from a cooperative agreement provided to the State of Connecticut by the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration.

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Correspondence to Robey B. Champine.

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Champine, R.B., Shaker, A.H., Tsitaridis, K.A. et al. Service-Related Barriers and Facilitators in an Early Childhood System of Care: Comparing the Perspectives of Parents and Providers. Community Ment Health J 55, 942–953 (2019) doi:10.1007/s10597-019-00418-4

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  • System of care
  • Early childhood
  • Service access
  • Qualitative analysis