Well-Child Care Redesign: A Mixed Methods Analysis of Parent Experiences in the PARENT Trial

被引:15
|
作者
Mimila, Naomi A. [1 ]
Chung, Paul J. [1 ,2 ,3 ]
Elliott, Marc N. [2 ]
Bethell, Christina D. [4 ]
Chacon, Sandra [1 ]
Biely, Christopher [1 ]
Contreras, Sandra [1 ]
Chavis, Toni [5 ]
Bruno, Yovana [6 ]
Moss, Tanesha [1 ]
Coker, Tumaini R. [7 ,8 ]
机构
[1] UCLA, David Geffen Sch Med, Mattel Childrens Hosp, Childrens Discovery & Innovat Inst, Los Angeles, CA 90095 USA
[2] RAND, Santa Monica, CA USA
[3] UCLA, Fielding Sch Publ Hlth, Los Angeles, CA USA
[4] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
[5] Wee Care Associates, Compton, CA USA
[6] YBPC, Duarte, CA USA
[7] Univ Washington, Seattle, WA 98195 USA
[8] Seattle Childrens Res Inst, Seattle, WA USA
关键词
practice redesign; preventive care; randomized controlled trial; well-child care; CLINICAL-PRACTICE REDESIGN; YOUNG-CHILDREN; QUALITY; INTERVENTION; AGREEMENT; SERVICES;
D O I
10.1016/j.acap.2017.02.004
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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.
引用
收藏
页码:747 / 754
页数:8
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