Well-Child Care Redesign

A Mixed Methods Analysis of Parent Experiences in the PARENT Trial

Published in: Academic Pediatrics Volume 17, Issue 7 (September-October 2017), Pages 747-754. doi: 10.1016/j.acap.2017.02.004

Posted on RAND.org on September 28, 2017

by Naomi A. Mimila, Paul J. Chung, Marc N. Elliott, Christina Bethell, Sandra Chacon, Christopher Biely, Sandra Contreras, Toni Chavis, Yovana Bruno, Tanesha Moss, Tumaini Coker

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Background

Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), is a well-child care (WCC) model that has demonstrated effectiveness in improving the receipt of comprehensive WCC services and reducing emergency department utilization for children aged 0 to 3 in low-income communities. PARENT relies on a health educator ("parent coach") to provide WCC services; it utilizes a Web-based previsit prioritization/screening tool (Well-Visit Planner) and an automated text message reminder/education service. We sought to assess intervention feasibility and acceptability among PARENT trial intervention participants.

Methods

Intervention parents completed a survey after a 12-month study period; a 26% random sample of them were invited to participate in a qualitative interview. Interviews were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis; survey responses were analyzed using bivariate methods.

Results

A total of 115 intervention participants completed the 12-month survey; 30 completed a qualitative interview. Nearly all intervention participants reported meeting with the coach, found her helpful, and would recommend continuing coach-led well visits (97–99%). Parents built trusting relationships with the coach and viewed her as a distinct and important part of their WCC team. They reported that PARENT well visits more efficiently used in-clinic time and were comprehensive and family centered. Most used the Well-Visit Planner (87%), and found it easy to use (94%); a minority completed it at home before the visit (18%). Sixty-two percent reported using the text message service; most reported it as a helpful source of new information and a reinforcement of information discussed during visits.

Conclusions

A parent coach-led intervention for WCC for young children is a model of WCC delivery that is both acceptable and feasible to parents in a low-income urban population.

Research conducted by

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