Tumaini R Coker1, Sandra Chacon2, Marc N Elliott3, Yovana Bruno4, Toni Chavis5, Christopher Biely2, Christina D Bethell6, Sandra Contreras2, Naomi A Mimila2, Jeffrey Mercado2, Paul J Chung7. 1. UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California; RAND, Santa Monica, California; tcoker@mednet.ucla.edu. 2. UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California; 3. RAND, Santa Monica, California; 4. YBPC, Duarte, California; 5. Wee Care Associates, Compton, California; 6. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and. 7. UCLA Children's Discovery & Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California; RAND, Santa Monica, California; UCLA Fielding School of Public Health, Los Angeles, California.
Abstract
OBJECTIVE: The goal of this study was to examine the effects of a new model for well-child care (WCC), the Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), on WCC quality and health care utilization among low-income families. METHODS: PARENT includes 4 elements designed by using a stakeholder-engaged process: (1) a parent coach (ie, health educator) to provide anticipatory guidance, psychosocial screening and referral, and developmental/behavioral guidance and screening at each well-visit; (2) a Web-based tool for previsit screening; (3) an automated text message service to provide periodic, age-specific health messages to families; and (4) a brief, problem-focused encounter with the pediatric clinician. The Promoting Healthy Development Survey-PLUS was used to assess receipt of recommended WCC services at 12 months' postenrollment. Intervention effects were examined by using bivariate analyses. RESULTS: A total of 251 parents with a child aged ≤12 months were randomized to receive either the control (usual WCC) or the intervention (PARENT); 90% completed the 12-month assessment. Mean child age at enrollment was 4.5 months; 64% had an annual household income less than $20,000. Baseline characteristics for the intervention and control groups were similar. Intervention parents scored higher on all preventive care measures (anticipatory guidance, health information, psychosocial assessment, developmental screening, and parental developmental/behavioral concerns addressed) and experiences of care measures (family-centeredness, helpfulness, and overall rating of care). Fifty-two percent fewer intervention children had ≥2 emergency department visits over the 12-month period. There were no significant differences in WCC or sick visits/urgent care utilization. CONCLUSIONS: A parent coach-led model for WCC may improve the receipt of comprehensive WCC for low-income families, and it may potentially lead to cost savings by reducing emergency department utilization.
RCT Entities:
OBJECTIVE: The goal of this study was to examine the effects of a new model for well-child care (WCC), the Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), on WCC quality and health care utilization among low-income families. METHODS: PARENT includes 4 elements designed by using a stakeholder-engaged process: (1) a parent coach (ie, health educator) to provide anticipatory guidance, psychosocial screening and referral, and developmental/behavioral guidance and screening at each well-visit; (2) a Web-based tool for previsit screening; (3) an automated text message service to provide periodic, age-specific health messages to families; and (4) a brief, problem-focused encounter with the pediatric clinician. The Promoting Healthy Development Survey-PLUS was used to assess receipt of recommended WCC services at 12 months' postenrollment. Intervention effects were examined by using bivariate analyses. RESULTS: A total of 251 parents with a child aged ≤12 months were randomized to receive either the control (usual WCC) or the intervention (PARENT); 90% completed the 12-month assessment. Mean child age at enrollment was 4.5 months; 64% had an annual household income less than $20,000. Baseline characteristics for the intervention and control groups were similar. Intervention parents scored higher on all preventive care measures (anticipatory guidance, health information, psychosocial assessment, developmental screening, and parental developmental/behavioral concerns addressed) and experiences of care measures (family-centeredness, helpfulness, and overall rating of care). Fifty-two percent fewer intervention children had ≥2 emergency department visits over the 12-month period. There were no significant differences in WCC or sick visits/urgent care utilization. CONCLUSIONS: A parent coach-led model for WCC may improve the receipt of comprehensive WCC for low-income families, and it may potentially lead to cost savings by reducing emergency department utilization.
Authors: Tumaini R Coker; Helen M DuPlessis; Ramona Davoudpour; Candice Moreno; Michael A Rodriguez; Paul J Chung Journal: Acad Pediatr Date: 2011-11-10 Impact factor: 3.107
Authors: Chuck Norlin; Morgan A Crawford; Christopher T Bell; Xiaoming Sheng; Martin T Stein Journal: Acad Pediatr Date: 2011 Jan-Feb Impact factor: 3.107
Authors: Oscar W Brown; Amy Hardin; Herschel R Lessin; Kelley Meade; Scot Moore; Chadwick T Rodgers; Edward S Curry; Paula M Dunca; Joseph F Hagan; Alex R Kemper; Judith S Shaw; Jack T Swanson Journal: Pediatrics Date: 2014-02-24 Impact factor: 7.124
Authors: Cynthia S Minkovitz; Donna Strobino; Kamila B Mistry; Daniel O Scharfstein; Holly Grason; William Hou; Nicholas Ialongo; Bernard Guyer Journal: Pediatrics Date: 2007-09 Impact factor: 7.124
Authors: Erin Fries Taylor; Rachel M Machta; David S Meyers; Janice Genevro; Deborah N Peikes Journal: Ann Fam Med Date: 2013 Jan-Feb Impact factor: 5.166
Authors: Naomi A Mimila; Paul J Chung; Marc N Elliott; Christina D Bethell; Sandra Chacon; Christopher Biely; Sandra Contreras; Toni Chavis; Yovana Bruno; Tanesha Moss; Tumaini R Coker Journal: Acad Pediatr Date: 2017-02-14 Impact factor: 3.107
Authors: Emily A Eismann; Bin Zhang; Matthew Fenchel; Alonzo T Folger; Jill Huynh; Joseph M Bailey; Robert A Shapiro Journal: Prev Sci Date: 2022-10-12
Authors: Courtney K Blackwell; Maxwell Mansolf; Phillip Sherlock; Jody Ganiban; Julie A Hofheimer; Charles J Barone; Traci A Bekelman; Clancy Blair; David Cella; Shaina Collazo; Lisa A Croen; Sean Deoni; Amy J Elliott; Assiamira Ferrara; Rebecca C Fry; Richard Gershon; Julie B Herbstman; Margaret R Karagas; Kaja Z LeWinn; Amy Margolis; Rachel L Miller; T Michael O'Shea; Christina A Porucznik; Rosalind J Wright Journal: Pediatrics Date: 2022-04-01 Impact factor: 9.703
Authors: R Christopher Sheldrick; Susan Marakovitz; Daryl Garfinkel; Alice S Carter; Ellen C Perrin Journal: JAMA Pediatr Date: 2020-04-01 Impact factor: 16.193
Authors: Abraham Gallegos; Rebecca Dudovitz; Christopher Biely; Paul J Chung; Tumaini R Coker; Elizabeth Barnert; Alma D Guerrero; Peter G Szilagyi; Bergen B Nelson Journal: Acad Pediatr Date: 2021-05-19 Impact factor: 2.993