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

作者：Mimila Naomi A; Chung Paul J; Elliott Marc N; Bethell Christina D; Chacon Sandra; Biely Christopher; Contreras Sandra; Chavis Toni; Bruno Yovana; Moss Tanesha; Coker Tumaini R^*

来源：Academic Pediatrics, 2017, 17(7): 747-754.

DOI：10.1016/j.acap.2017.02.004

• practice redesign
• preventive care
• randomized controlled trial
• well-child care

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.

• 出版日期2017-10
• 单位UCLA