Sarah D Ronis1, Kristi K Westphaln2, Lawrence C Kleinman3, Stephen J Zyzanski4, Kurt C Stange5. 1. Department of Pediatrics (SD Ronis), Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals Rainbow Babies and Children's Hospital (SD Ronis and KK Westphaln), Cleveland, Ohio; UH Rainbow Center for Child Health and Policy (SD Ronis), Cleveland, Ohio. Electronic address: sarah.ronis@UHHospitals.org. 2. University Hospitals Rainbow Babies and Children's Hospital (SD Ronis and KK Westphaln), Cleveland, Ohio; Department of Bioethics (KK Westphaln), Case Western Reserve University School of Medicine, Cleveland, Ohio. 3. Department of Pediatrics (LC Kleinman), Rutgers University Robert Wood Johnson School of Medicine, New Brunswick, NJ. 4. Center for Community Health Integration, Departments of Family Medicine & Community Health, Population and Quantitative Health Sciences, Sociology, Case Comprehensive Cancer Center (SJ Zyzanski and KC Stange), Case Western Reserve University, Cleveland, Ohio. 5. Center for Community Health Integration, Departments of Family Medicine & Community Health, Population and Quantitative Health Sciences, Sociology, Case Comprehensive Cancer Center (SJ Zyzanski and KC Stange), Case Western Reserve University, Cleveland, Ohio; Larry A. Green, MD Center for the Advancement of Primary Health Care for the Public Good (KC Stange), Richmond, Va.
Abstract
OBJECTIVE: Improvement efforts in pediatric primary care would benefit from measures that capture families' holistic experience of the practice. We sought to assess the reliability and validity of the new Person-Centered Primary Care Measure (PCPCM) in a pediatric resident continuity clinic serving low-income families. METHODS: We incorporated the 11-item PCPCM, stems adapted to reflect a parent responding about their child's visit, into a telephone survey of 194 parents presenting for care in October 2019 at a pediatric resident continuity clinic in Cleveland Ohio (64% response rate). We evaluated PCPCM items using factor analysis and Rasch modeling, and assessed associations of the PCPCM with parents' demographics and perceptions of specific elements of their child's care. RESULTS: In this sample of low-income families, the PCPCM had good reliability (Cronbach's alpha 0.85). All items loaded onto a single factor in principal axes factor analysis. Of the 11 aspects of primary care represented in the scale, "shared experience" was most difficult for parents to endorse in Rasch modeling. All 11 items contributed significantly to the total scale score with corrected item-total correlations >0.4. The PCPCM score was independent of socio demographics and was associated with parent's report that their child's clinician spends enough time with them. CONCLUSIONS: The PCPCM performs well in a pediatric continuity clinic setting, warranting consideration for its use as a parsimonious parent-reported measure of what patients and clinicians say matters most in pediatric primary care.
OBJECTIVE: Improvement efforts in pediatric primary care would benefit from measures that capture families' holistic experience of the practice. We sought to assess the reliability and validity of the new Person-Centered Primary Care Measure (PCPCM) in a pediatric resident continuity clinic serving low-income families. METHODS: We incorporated the 11-item PCPCM, stems adapted to reflect a parent responding about their child's visit, into a telephone survey of 194 parents presenting for care in October 2019 at a pediatric resident continuity clinic in Cleveland Ohio (64% response rate). We evaluated PCPCM items using factor analysis and Rasch modeling, and assessed associations of the PCPCM with parents' demographics and perceptions of specific elements of their child's care. RESULTS: In this sample of low-income families, the PCPCM had good reliability (Cronbach's alpha 0.85). All items loaded onto a single factor in principal axes factor analysis. Of the 11 aspects of primary care represented in the scale, "shared experience" was most difficult for parents to endorse in Rasch modeling. All 11 items contributed significantly to the total scale score with corrected item-total correlations >0.4. The PCPCM score was independent of socio demographics and was associated with parent's report that their child's clinician spends enough time with them. CONCLUSIONS: The PCPCM performs well in a pediatric continuity clinic setting, warranting consideration for its use as a parsimonious parent-reported measure of what patients and clinicians say matters most in pediatric primary care.
Authors: Kurt C Stange; William L Miller; Paul A Nutting; Benjamin F Crabtree; Elizabeth E Stewart; Carlos Roberto Jaén Journal: Ann Fam Med Date: 2010 Impact factor: 5.166