Well-Child Care Redesign: A Mixed Methods Analysis of Parent Experiences in the PARENT Trial
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, 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
Abstract
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.
Keywords: practice redesign; preventive care; randomized controlled trial; well-child care.
Conflict of interest statement
Conflicts of Interest: The authors have no conflicts of interests to disclose.
Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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Source: PubMed