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Table 1 Themes on parent’s experiences for accessing primary health care within the ecological framework

From: Explaining culturally and linguistically diverse (CALD) parents’ access of healthcare services for developmental surveillance and anticipatory guidance: qualitative findings from the ‘Watch Me Grow’ study

Ecological framework

Themes

Microsystem: The microsystem is a “pattern of activities, roles, and interpersonal relations experienced by the developing person with particular physical, social, and symbolic features that invite, permit, or inhibit, engagement in sustained, progressively more complex interaction with, and activity in, the immediate environment” [33].

Parental concerns about their child health and development, ‘just to know he is on track’

(Beliefs)

Sources of Information and support for parents, ‘ If I get help it’s going to be easier for me’

(Awareness/Choices)

Mesosystem: The mesosystem is comprised of the relationships that exist between two or more settings [33].

Lack of knowledge about health system and community health services, The Blue Book, ‘Nobody told me’

(Awareness of where to access information, uncertainty of choice)

Choice of provider (Choices)

CALD parents’ understanding of the CFHN role

CALD parents’ understanding of the GP role

‘The importance of language’

Parents’ previous experiences with CFHNs and GPs

(Based on different factors such as proximity, continuity of care, purpose of visit, language spoken by the provider)

Exosystem: The exo-system refers to settings and events that influence a child’s development indirectly. This includes contexts, factors and events that may affect parents and thus impact their children.

No new themes emerged within this context

Macrosystems:The macrosystem refers to consistencies, in the form and content of lower-order systems (micro-,meso-, and exo-) that exist, or could exist, at the level of the sub-culture or the culture as a whole, along with any belief systems or ideology underlying such consistencies” [32].

Comparison with other health systems

Awareness and choice

Chronosystems: This concept acknowledges that physical and human ecologies change over time, which includes environmental events, life transitions and socio-historical events.

Increased awareness over time

Awareness of changes to services