FOCUS GROUP

THEMES

ANALYSIS METHODS • Text Transcribed from Audiotape

• Analyzed with NVivo Qualitative Analysis Software

• Text transformed using Jim Gee Narrative Analysis Method – Parsed into stanzas

• Themes identified in preliminary analysis

• Qualitative Methods – staying close to participants’ words

THEMES

• How these young people navigate care systems

• Positive and negative aspects of health care

• The transition from childhood to adulthood

• Stress

• Trusted sources of advice

LIFE

THREATENING

ILLNESS

Closest Hospital

Highland

Best place for trauma

Nasty ass

food

Long Waits

Don’t do shit for you

Shorter waits

Life Threatening Illness – Highland

It's like at Highland if you don’t have a life threatening thing they don’t give a fuck about you.

LIFE THREATING ILLNESS – HIGHLAND

AS BEST PLACE FOR TRAUMA

'Cause I spent like two weeks up in there at Highland. I ain't spend no overnight at Children’s. They cool at Highland though. The food and shit ain't cool probably cuz it’s county, but the nurses and the intensive care –

But at the same time, that's how good they is with they intensive care 'cause I ain't gonna lie. They good. I heard they one of the best just on strength of like how they handle intensive care for real.

HIGHLAND – “THEY DON’T DO SHIT

FOR YOU”

Moderator: Would you return if it was your choice? M5: No. Moderator: Why not? M5: Because it takes a long time for you to get your attention to somebody.

M4: Yeah, because you go and you wait like five hours, three hours and they don't even do shit to you. I could do that at home by myself.

LIFE THREATENING ILLNESS –

CLOSEST HOSPITAL

M3: I just go wherever the closest. If you're hurt, if you hurt bad enough and need to go to the doctor, you go to the closest one.

NON LIFE

THREATENING

ILLNESS

Children’s

Folk Medicine

Kaiser Women

Warm food

Treated like a kid

Little Big Boy

Not the best place for trauma

Outgrew Children’s

White People

Marijuana

Shorter Waits

More Effective

Care

Children

Family Member

Treatment

FOLK MEDICINE – HOME TREATMENT

M3: Same thing. One time I got shot in my arm, I didn't go to the hospital my partner just wrapped that up. M3: Yeah. His mom pulled it out with a tweezer

and something else she just pulled that shit out and then wrapped that shit up. Like outside in two hours later. It is a waste of time. I was thinking that after the first time I got shot, then the second time it was a waste of time. I don't need to be sittin' up in there

FOLK MEDICINE - MARIJUANA

Moderator: Where do you usually go for care? Male5: Where do I go for care? Moderator: Yeah. If you're sick or hurt. Male5: To Cannibus. I swear to god. Moderator : What about DeeDee. Speak on a little bit, DeeDee. Male1: To the cannibus.

FOLK MEDICINE - MARIJUANA

M4: I get that at the house. I can get some fuckin' weed instead of fuckin' with Vicodin. That shit just get your head dizzy M3: If I get sick I just smoke weed, smoke a couple blunts. I be good.

My grandma was sick, right, and I gave her a blunt to smoke. Man, she can breathe again real good, man She real cool. I told her get this blunt right here, hit this blunt

FOLK MEDICINE – MARIJUANA

(CONTINUED) Well, tell me her nose was stopped up. She couldn't even blow her nose. Man, hit this weed right here. Went off, came back. Man, she was walkin' around the house even got a plate of food, breathin' again.

All that goin' to the hospital for $10.00. That's gonna waste your time You can smoke this blunt in 5 minutes and be cool in 10. M4: And go to sleep in 20.

FOLK MEDICINE – EFFECTIVE AND

TIMELY What are some of the why you might go to the cannibus club or you might go to an elder in your family? M3: 'Cause when you go then you can just get in and out. You ain't gotta be wastin' time sittin' there and just lookin' at the TV or playin' with your phone -- Male3: Yeah. That's a big waste of time. You can do the same thing just sittin' at home.

POSITIVE AND NEGATIVE

ASPECTS OF MEDICAL CARE

GOOD

CARE Shorter Waits

Treated like a kid

Thorough& Timely

Warm Food

Cool Doctor

Effective Treatment

They pay attention

COOL DOCTOR M3: Whenever I’ve been in there, what doctor was cool and which one wasn't. You can basically tell how they act 'cause you gonna act the same way. They actin' messed up, you gonna be messed up. They cool, you cool.

GOOD CARE - ATTENTION

Moderator: What is it that felt different when you were at Kaiser? M5: Soon as you walk in they got your attention. They start treating you. What's wrong with you? You're basically in and out.

M4: Kaiser, three, four hours 'cause I went there for my baby boo four hours and they did all the check-up and I was out of there.

GOOD CARE – THOROUGH AND

TIMELY Moderator: When you went back, what would you expect or would you want out of the doctors or the nurses who were helping you? M5: Shit, just to check me. Check me. Check my injury. Check it right M4: Do it faster, huh.

M5: Not faster, but take care of it. M4: Not to check it faster but take care of business faster. M5: Yeah.

CHILDREN’S– TREATED LIKE A KID

Moderator: How did you feel you were treated? M1: Extra good. Like a kid or somethin'. Take care of me Moderator: What does that mean take care? M4: They pay more attention to you. They give you warm food. They give you real food. Pizza, pie and all that good shit. M1: They care about the little big boy.

GOOD

CARE

BAD CARE

Shorter Waits

Treated like a kid

Thorough& Timely

Warm Food

Cool Doctor

Effective Treatment

Long Waits

MistrustDiagnosis

No Physical

Exam

Waste of time

Ineffective Care

Don’t do shit for

you

Nasty ass food

County Care

Perceived Incompetence

Stigma

They pay attention

Impersonal Care -

Paperwork

PAPERWORK – INEFFECTIVE CARE Let me holler at you let me see your paperwork. How you feelin'? Good. Alright, bam. Throw it back out. Do whatever we gotta do. Come back. "Oh, you still here?" "Yeah, you haven't seen me." "Okay. Let me see you." Bam, bam, bam. "Okay, you cool.

Come back in two, three weeks." Say what the fuck?

They just write stuff on the paper. This what was wrong with you last time. This what's wrong with you this time. This is getting better. Okay. Bam. Two week check-up, see how you're doin'. Come back and that's it. Aint nobody gonna come back because you didn't do nothin' while I was there.

IMPERSONAL CARE - PAPERWORK

They goin' by just what's on this paper. A year ago this was on this paper. Thirty months ago this was on this paper. Three days ago this was on this paper. When you was born this was on this paper. This is your mama paper. This one's goin' back to you. How I suppose to know what's wrong with me if you dependin' on paper? Y'all know nothin'. You just know what's on that paper.

BAD CARE NARRATIVE - MISTRUST

One time my cousin, he was in there. He was there 'cause he said his breathin' was bad or somethin'. He got somethin' on his chest or somethin'. So he went up in there or he went to the doctor or whatever.

I realized that they didn't even listen to his chest or try to see what was wrong with his breathin'. They just said, "This is what's wrong with you." They didn't even say what was wrong.

BAD CARE NARRATIVE – MISTRUST

(CONTINUED) They didn’t touch your chest or nothin. He's like, "I know they be hella scandoulous." Like if you had a snake in your chest they wouldn't even care. "Well, your pipes are congested." That's what might be wrong with you.

Then they give you medicine. What they give you for medicine for something and they don’t know what is wrong with you? What if it's somethin' else, but they give you medicine for this?

BAD CARE - STIGMA

Sometimes you do need a prescription and just by how you actin', how you look, the doctor would be like, "No, you need it because you wanna get high." I'm gonna get high if I need it. You haven’t been knowin what I went through. You seen it or I gotta get to know you. What do you gotta get to know me for? You already seen my record that’s all you need to know about me.

BAD CARE – PERCEIVED

INCOMPETENCE Moderator: So what happened? M4: Some silly ass nurses_ -- M3: Yeah. I know 'cause they do a lot of stuff, but they be silly. I had to tell her what to do. I'm like, "Don't you supposed to do this and do this? Don't you suppose to wipe this and this?”

She was like, "Oh yeah. I forgot." Like how you forget? M4: watcha doin'. So how you stupid. I'm like, "Ya' know what? Just give me the supplies. I need this, this and that. Just go get it and I'll do the rest.”

BAD CARE - COUNTY CARE Everything within the county takes so long. It's like if you goin' to the GA office to get your ID or somethin' like that, that take long or the DMV. For some reason the DMV . . . the jail, the GA office, the hospital, all run by the county, but they all resemble the same kinda' like not give a care-ency. Ya' feel me?

CHILDHOOD AND TRANSITION

FROM CHILDHOOD TO

ADULTHOOD

TRANSITION FROM CHILDHOOD TO

ADULTHOOD – MORE TO LOSE

I say you just grow out of it. You just grow up out of it. That shit before you don't wanna do. You think about it, like they were sayin'. You think about it twice. It's not like you're young no more. You got more shit to lose now than back then.

CHILDREN AS MOTIVATORS FOR

CHANGE What's helped you or is helping you now to get better? M4: Seein' my little daughter. Think about it twice before I do somethin' stupid. M1: That's 88 percent of it right there. Moderator: For you, too? M1: Yeah. My son is my life.

STRESS AND DANGER

STRESS/DANGER

If we at a store where we know last year two or three people just got banged on that right there on that GPS right there Come on. So what makes you think that we go there?

STRESS/INEVITABLE DANGER

[Positive support] is for the community. It ain't just for people that's getting shot 'cause the people that ain't getting shot is goin' through the same stuff. Like I say, I got people that I know that walked around lookin' over they shoulders and they ain't never shot a gun or been fucked up with nobody ever in they life. That's just the way it is.

STRESS/SUICIDE

Yeah. But just for some reason, how the streets work, for some reason the people who just end up who I hear shootin' or whatever, they end up dead. I can't say God works in mysterious ways, but that's just how the streets work. Ya' know what I mean?

Some niggas' they kill they self. M4: Stressin'. M1: For real. M4: Can't deal with it M1: For real. Some niggas kill themselves. Not even meanin' to.

VIOLENCE AS DESTINY Shit, just tell them man, we was born to live. One day we gotta die. So today's your day, shit, you gotta die. There's nothin' you can do about it. If it's your day, it's your day. M1: For real.

M3: For real. If it is, it's gonna come how it's gonna come -- M4: That's how your destiny is M3: 'cause you kickin' it with us you gonna make your bed and lay in it in the same time. So if this what you doin' wrong, this is what's gonna come wrong.

ACTIONS HAVE CONSEQUENCES –

YOU COULD CHOOSE POSITIVE LIFE That's right. You gotta get on that positive life. You fixin' to be on this with the shit and there's consequences. If you don’t' want this, you fixin' to get up outta' here – Go get a job or somethin' –

M4: Goin' through the right way. Don't do this. That's it. M1: That's what I did. Ain't nothin' wrong with doin' that. M4: Yeah. You could choose not to go kick no more --

TRUST

RAPHAEL – ACCEPTANCE &

RELIABILITY M4: We can talk to him, everyone, like in the slang or in our accents like how we is -- M3: Straightforward -- M4: And then he can still talk to us cool. Not like everybody else. Not like these guys came from somebody else. After listenin' to him, getting advice or stuff. I'm gonna help you out.

They never call you back or nothin'. You call at four shit and forget about you. All that. He don't. He just be, "Alright, I'm gonna try to do this.” And if not then he'll just give you a call back. "Oh, I can't do it today. Just give me two, three more days or somethin’ and I'll get back at ya'.”

RAPHAEL - COOL Male3: 'Cause he cool. You ain't gotta be nobody different, man. You just be yourself. No matter if you bad, good, sick, green, purple, ugly, man. If you know how to talk, he understandin'. He gonna talk to you. If not, he's just gonna be like, "I can't help you."

Or he gonna tell you why he can't help you because this person is being a cat or this, this, this. He ain’t speakin' down to you he just said, "Well we can't do it because of this reason." If you can be the bigger person like okay, that's it, then when the next time maybe it be better for you.

RAPHAEL - TRUST

M3: He’ll come through for sure no matter where you at. He makes sure ask you if you fuck with somebody over here M4: He wanna pick them up, ride them over here and stuff like that,see? If it wasn't for him, he wouldn't even be here. That’s how you get out of the hospital. M5: That's solid.

M4: Yeah. and he stay out the way. So he went out of his way to go get somebody, bring them over here and bring him over here. Moderator: Anybody else that wants to talk to about who do you go to in your community? M4: Well that's most likely everybody fuck with Ralph.

SOURCES OF ADVICE

ADVICE - TEACHERS

It depends on if the teacher cool or not. I went to Mac so most of the teachers there are cool 'cause they mainly ghetto. So you can't be right or wrong 'cause then they just gotta know how you feel, but it depends on if the teacher cool or not. .

ADVICE – SOCIAL WORKER Somebody told me that your social worker is lyin’. Several people have told you that your social worker's lyin'. A dozen people started tellin' you that your social worker's lyin' to you. So you startin' to think like more people tell you that the social worker's lyin' or might lead you to a wrong way or lead you astray or somethin' like that. They tell me like, "I know somebody who received it. No, they didn't have to tell them about it. No, you don't have to work."

ADVICE – SOCIAL WORKER

They tellin' me you either have to, okay, tell on somebody or whatever. That maybe snitch or whatever and then they tellin' me you probably have to work or work a job around the time you got shot. I was out here on break from school.

VICTIM COMPENSATION

Your paper gonna work if you turn in some paperwork. I'm tellin' you. The only way your paper gonna work is if you turn in some paperwork. I told em what's up with these recorders. I don't need that. I told them, "I don't need the money if I gotta tell on nobody. That ain't cool."

M1: I'm not tellin' nobody. Even if I did know 'cause that'd put your life in jeopardy M3: They gotta give me a million dollars every month for my life for me to tell on somebody ’ cause that nah man hell naw.

ADVICE - POLICE

I can't speak for everybody, but people I know under ages 40, 50, it's somethin' like religion, but people don't listen to suggestions from police officers Ya' know what I mean? They really don't. People don't.

ADVICE – PROBATION

OFFICER Me? I'd rather not even deal with no parole. True story. I’d rather not even deal with nobody's police officer or correctional officer, nobody's police officer. I'd rather deal with a nurse or a doctor like I've been doin'.

They try to make you do stuff and stuff like that so I'd rather just live my life happy, just try to grow into a man. I know what my priorities is. I don't need nobody else to enforce them or tell me or make me do when I gotta go to the bathroom or stuff like that. So I don't know.

NEXT STEPS

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• Use focus groups for feedback on draft assessment tool