Low-income parents' views on the redesign of well-child care.

Abstract:

OBJECTIVE:To examine the perspectives of low-income parents on redesigning well-child care (WCC) for children aged 0 to 3 years, focusing on possible changes in 3 major domains: providers, locations, and formats. METHODS:Eight focus groups (4 English and 4 Spanish) were conducted with 56 parents of children aged 6 months to 5 years, recruited through a federally qualified health center. Discussions were recorded, transcribed, and analyzed by using the constant comparative method of qualitative analysis. RESULTS:Parents were mostly mothers (91%), nonwhite (64% Latino, 16% black), and <30 years of age (66%) and had an annual household income of <$35000 (96%). Parents reported substantial problems with WCC, focusing largely on limited provider access (especially with respect to scheduling and transportation) and inadequate behavioral/developmental services. Most parents endorsed nonphysician providers and alternative locations and formats as desirable adjuncts to usual physician-provided, clinic-based WCC. Nonphysician providers were viewed as potentially more expert in behavioral/developmental issues than physicians and more attentive to parent-provider relationships. Some alternative locations for care (especially home and day care visits) were viewed as creating essential context for providers and dramatically improving family convenience. Alternative locations whose sole advantage was convenience (eg, retail-based clinics), however, were viewed more skeptically. Among alternative formats, group visits in particular were seen as empowering, turning parents into informal providers through mutual sharing of behavioral/developmental advice and experiences. CONCLUSIONS:Low-income parents of young children identified major inadequacies in their WCC experiences. To address these problems, they endorsed a number of innovative reforms that merit additional investigation for feasibility and effectiveness.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Coker TR,Chung PJ,Cowgill BO,Chen L,Rodriguez MA

doi

10.1542/peds.2008-2608

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

194-204

issue

1

eissn

0031-4005

issn

1098-4275

pii

124/1/194

journal_volume

124

pub_type

杂志文章
  • Increasing antiretroviral drug access for children with HIV infection.

    abstract::Although there have been great gains in the prevention of pediatric HIV infection and provision of antiretroviral therapy for children with HIV infection in resource-rich countries, many barriers remain to scaling up HIV prevention and treatment for children in resource-limited areas of the world. Appropriate testing ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-0273

    authors: American Academy of Pediatrics Committee on Pediatric AIDS, Section on International Child Health.,Havens PL,Gibb DM

    更新日期:2007-04-01 00:00:00

  • High-density lipoprotein-cholesterol subfractions in adolescent twins.

    abstract::Data on the levels of high-density lipoprotein-cholesterol (HDL-C) and subfractions in 102 adolescent twin pairs and their parents are presented. Children with a family history of premature cardiovascular death had lower levels of HDL2-C than did those without such a history. White girls reporting a high level of phys...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Bodurtha JN,Schieken R,Segrest J,Nance WE

    更新日期:1987-02-01 00:00:00

  • Barriers to domestic violence screening in the pediatric setting.

    abstract:OBJECTIVE:By surveying practitioners in our community, we hoped to determine what pediatricians and family physicians (FPs) perceive as barriers to the American Academy of Pediatrics (AAP) Recommendation on Domestic Violence Screening. BACKGROUND:When screened in the pediatric setting, as many as 40% of mothers will d...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.108.1.98

    authors: Erickson MJ,Hill TD,Siegel RM

    更新日期:2001-07-01 00:00:00

  • Hospitalizations of newborns with folate-sensitive birth defects before and after fortification of foods with folic acid.

    abstract:CONTEXT:The prevalence of neural tube defects is reduced in populations of women who receive folic acid supplementation. Since 1998, grain products in the United States have been fortified with folic acid. Fortification may have additional benefits by reducing the national prevalence of newborn hospitalizations for oth...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2005-2784

    authors: Robbins JM,Tilford JM,Bird TM,Cleves MA,Reading JA,Hobbs CA

    更新日期:2006-09-01 00:00:00

  • Antibody response to diphtheria-tetanus-pertussis immunization in preterm infants who receive dexamethasone for chronic lung disease.

    abstract:OBJECTIVE:To study the effect of dexamethasone in preterm infants with chronic lung disease (CLD) on antibody response to routine immunization against diphtheria, tetanus, and pertussis (DTP). METHODS:Serum samples were obtained before and after immunization with DTP (Trivax-AD) from an unselected cohort of 93 preterm...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.113.4.733

    authors: Robinson MJ,Heal C,Gardener E,Powell P,Sims DG

    更新日期:2004-04-01 00:00:00

  • Use and yield of chest computed tomography in the diagnostic evaluation of pediatric lung disease.

    abstract:OBJECTIVE:Computed tomography is commonly used in the diagnosis of pediatric lung disease. Although the radiation is not negligible, the yield has never been studied. METHODS:Clinical and imaging data were collected for all children who underwent chest computed tomography, as part of the diagnostic process. Cases were...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-2694

    authors: Schneebaum N,Blau H,Soferman R,Mussaffi H,Ben-Sira L,Schwarz M,Sivan Y

    更新日期:2009-08-01 00:00:00

  • Previsit Screening for Parental Vaccine Hesitancy: A Cluster Randomized Trial.

    abstract:OBJECTIVE:To evaluate the effect of vaccine hesitancy screening on childhood vaccine uptake. METHODS:We conducted a cluster randomized controlled trial in pediatric primary care clinics in Washington state. Vaccine-hesitant parents (VHPs) with a healthy newborn receiving health supervision at participating clinics wer...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2019-0802

    authors: Opel DJ,Henrikson N,Lepere K,Hawkes R,Zhou C,Dunn J,Taylor JA

    更新日期:2019-11-01 00:00:00

  • Tracheostomies and assisted ventilation in children with profound disabilities: navigating family and professional values.

    abstract::Parental requests for gastrostomies, tracheostomies, or assisted ventilation in children with profound disabilities raise ethical concerns about children's interests, parental decision-making, and health care costs. The underlying concern for many relates to the perceived value of these children. Clinicians should mak...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-3608H

    authors: Wilfond BS

    更新日期:2014-02-01 00:00:00

  • Toe tourniquet syndrome in association with maternal hair loss.

    abstract::Increased hair loss a few months after delivering an infant is a common postpartum condition known as telogen effluvium. A much less common condition involving young infants is the hair-thread tourniquet syndrome, or toe tourniquet syndrome, which involves hair or thread becoming so tightly wrapped around an appendage...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.111.3.685

    authors: Strahlman RS

    更新日期:2003-03-01 00:00:00

  • Assessment of children's health-related quality of life in the United States with a multidimensional index.

    abstract:OBJECTIVE:Using nationally representative data, we examined biological, medical system, and sociodemographic factors that are associated with health-related quality of life as measured by a multidimensional index that accounts for a wide range of child health domains. METHODS:Children aged > or = 6 years (N = 69,031) ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2007-0480

    authors: Simon AE,Chan KS,Forrest CB

    更新日期:2008-01-01 00:00:00

  • Increased blood pressure following pupillary dilation with 2.5% phenylephrine hydrochloride in preterm infants.

    abstract::Heart rate and blood pressure changes following 0.5% tropicamide and 2.5% phenylephrine hydrochloride were evaluated in seven ill preterm infants (birth weight, 910 to 2,060 gm; gestational age, 26 to 36 weeks) during the first day of life. Each infant was monitored continuously for 30 minutes before and for 75 minute...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Lees BJ,Cabal LA

    更新日期:1981-08-01 00:00:00

  • Intestinal lesions containing coronavirus-like particles in neonatal necrotizing enterocolitis: an ultrastructural analysis.

    abstract::Since the outbreaks of neonatal necrotizing enterocolitis occurring in maternity hospitals of Paris and suburbs in 1979-1980, it has been possible to examine by light and electron microscopy gut specimens from ten newborns with this illness. Coronavirus-like particles, enclosed in intracytoplasmic vesicles of damaged ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Rousset S,Moscovici O,Lebon P,Barbet JP,Helardot P,Macé B,Bargy F,Le Tan Vinh,Chany C

    更新日期:1984-02-01 00:00:00

  • Pain experience of children with headache and their families: A controlled study.

    abstract:OBJECTIVE:This study reports the pain sensitivity of children with headache and their family members, as well as the prevalence of recurring aches, psychosocial life, and family environment of children with headache at preschool age. DESIGN:A representative population-based sample of 1443 families expecting their firs...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.2.270

    authors: Aromaa M,Sillanpää M,Rautava P,Helenius H

    更新日期:2000-08-01 00:00:00

  • The pivotal role of deep vein thrombophlebitis in the development of acute disseminated staphylococcal disease in children.

    abstract::Deep vein thrombophlebitis (DVT) and septic pulmonary emboli (PE) are rare in children. The association of DVT and acute disseminated staphylococcal disease (DSD) during childhood has not been previously reported. We report 3 children who developed a triad of DVT, septic PE, and acute osteomyelitis with Staphylococcus...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.6.e87

    authors: Gorenstein A,Gross E,Houri S,Gewirts G,Katz S

    更新日期:2000-12-01 00:00:00

  • Morbidity among human immunodeficiency virus-1-infected and -uninfected African children.

    abstract:OBJECTIVE:To assess patterns of morbidity and associated factors in late infancy and early childhood among human immunodeficiency virus (HIV)-infected and -uninfected African children. DESIGN:Prospective study. SETTING:The Queen Elizabeth Central Hospital, Blantyre, Malawi. PARTICIPANTS:Children with known HIV statu...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.106.6.e77

    authors: Taha TE,Graham SM,Kumwenda NI,Broadhead RL,Hoover DR,Markakis D,van Der Hoeven L,Liomba GN,Chiphangwi JD,Miotti PG

    更新日期:2000-12-01 00:00:00

  • Time in continuity clinic as a predictor of continuity of care for pediatric residents.

    abstract:OBJECTIVE:In 1996, the Residency Review Committee-Pediatrics recommended doubling time in continuity clinic to 2 half days per week. It has yet to be demonstrated that increased time in clinic yields greater continuity of care. The objective of this study was to determine whether increasing the number of half days spen...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2003-0280-L

    authors: McBurney PG,Moran CM,Ector WL,Quattlebaum TG,Darden PM

    更新日期:2004-10-01 00:00:00

  • Impact of education for physicians on patient outcomes.

    abstract:OBJECTIVES:This study was conducted to assess the impact of an interactive seminar based on self-regulation theory on 1) the treatment practices and communications and education behavior of physicians, 2) the health status and medical care utilization of their pediatric patients with asthma, and 3) the satisfaction wit...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1542/peds.101.5.831

    authors: Clark NM,Gong M,Schork MA,Evans D,Roloff D,Hurwitz M,Maiman L,Mellins RB

    更新日期:1998-05-01 00:00:00

  • Controlled evaluation of muscle relaxation in the ventilated neonate.

    abstract::To assess the effects of muscle relaxation on the critically ill ventilated neonate, pancuronium bromide was administered for a 12-hour period to ten low-birth-weight neonates (960 to 2,000 gm) of 26 to 34 weeks gestation, all whom required mechanical ventilation and were studied within 48 hours of birth (six to 39 ho...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Finer NN,Tomney PM

    更新日期:1981-05-01 00:00:00

  • Gabapentin successfully manages chronic unexplained irritability in children with severe neurologic impairment.

    abstract::Neurologically impaired children have an increased frequency of recurrent pain and irritability that persist in some despite comprehensive evaluation and management of possible pain sources. We hypothesized that visceral hyperalgesia was a source of chronic unexplained irritability and report the outcome of gabapentin...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-1609

    authors: Hauer JM,Wical BS,Charnas L

    更新日期:2007-02-01 00:00:00

  • Not everything in the maxillary sinus is sinusitis: a case of a dentigerous cyst.

    abstract::A 4-year-old girl presented to a medical clinic with a painless right facial swelling. The treating physician ordered a radiograph of the sinuses and received a report of "maxillary sinusitis." After appropriate antibiotic treatment, the facial swelling increased, and the mother took the child to her community pediatr...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-1940

    authors: Haber R

    更新日期:2008-01-01 00:00:00

  • Prolonged rate-corrected QT interval and other electrocardiogram abnormalities in girls with Turner syndrome.

    abstract:BACKGROUND:We recently reported that electrocardiographic abnormalities are common in adults with monosomy X (Turner syndrome), but this issue has not been investigated in girls with Turner syndrome. PATIENTS AND METHODS:We analyzed electrocardiograms in 78 girls with Turner syndrome and 50 age-matched control girls. ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2006-0776

    authors: Bondy CA,Ceniceros I,Van PL,Bakalov VK,Rosing DR

    更新日期:2006-10-01 00:00:00

  • Fruit Consumption by Youth in the United States.

    abstract:OBJECTIVES:To describe the contribution of whole fruit, including discrete types of fruit, to total fruit consumption and to investigate differences in consumption by sociodemographic characteristics. METHODS:We analyzed data from 3129 youth aged 2 to 19 years from the National Health and Nutrition Examination Survey,...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2015-1709

    authors: Herrick KA,Rossen LM,Nielsen SJ,Branum AM,Ogden CL

    更新日期:2015-10-01 00:00:00

  • Reducing absenteeism from gastrointestinal and respiratory illness in elementary school students: a randomized, controlled trial of an infection-control intervention.

    abstract:BACKGROUND:Students often miss school because of gastrointestinal and respiratory illnesses. We assessed the effectiveness of a multifactorial intervention, including alcohol-based hand-sanitizer and surface disinfection, in reducing absenteeism caused by gastrointestinal and respiratory illnesses in elementary school ...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2007-2597

    authors: Sandora TJ,Shih MC,Goldmann DA

    更新日期:2008-06-01 00:00:00

  • Unilateral hearing loss is associated with worse speech-language scores in children.

    abstract:OBJECTIVE:To determine whether children with unilateral hearing loss (UHL) demonstrate worse language skills than their siblings with normal hearing, and whether children with UHL are more likely to receive extra assistance at school. PATIENTS AND METHODS:We conducted a case-control study of 6- to 12-year-old children...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2009-2448

    authors: Lieu JE,Tye-Murray N,Karzon RK,Piccirillo JF

    更新日期:2010-06-01 00:00:00

  • Trends in mortality and morbidity for very low birth weight infants, 1991-1999.

    abstract:BACKGROUND:Medical care for very low birth weight (VLBW) infants and their mothers has changed dramatically during the 1990s, yet it is unclear how these changes have affected mortality and morbidity. OBJECTIVE:We used the Vermont Oxford Network Database to identify trends in clinical practice and patient outcomes for...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究

    doi:10.1542/peds.110.1.143

    authors: Horbar JD,Badger GJ,Carpenter JH,Fanaroff AA,Kilpatrick S,LaCorte M,Phibbs R,Soll RF,Members of the Vermont Oxford Network.

    更新日期:2002-07-01 00:00:00

  • Trends in Capability of Hospitals to Provide Definitive Acute Care for Children: 2008 to 2016.

    abstract:BACKGROUND:Provision of high-quality care to acutely ill and injured children is a challenge to US hospitals because many have low pediatric volume. Delineating national trends in definitive pediatric acute care would inform improvements in care. METHODS:We analyzed emergency department (ED) visits by children between...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2019-2203

    authors: Michelson KA,Hudgins JD,Lyons TW,Monuteaux MC,Bachur RG,Finkelstein JA

    更新日期:2020-01-01 00:00:00

  • Assessment of neonatal encephalopathy by amplitude-integrated electroencephalography.

    abstract:OBJECTIVE:To define normal and abnormal patterns, test interobserver variability, and the prognostic accuracy of amplitude-integrated electroencephalography (aEEG) soon after the onset of neonatal encephalopathy. METHODS:Consecutive cases of neonatal encephalopathy (n = 56; gestation median, 40; range, 35-42 weeks) an...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.103.6.1263

    authors: al Naqeeb N,Edwards AD,Cowan FM,Azzopardi D

    更新日期:1999-06-01 00:00:00

  • A crossover, randomized, controlled trial of dornase alfa before versus after physiotherapy in cystic fibrosis.

    abstract:OBJECTIVE:Although dornase alfa is a widely used, aerosolized, mucolytic agent in patients with cystic fibrosis (CF), its efficacy in relation to the timing of physiotherapy has not been tested. We sought to determine whether dornase alfa is more efficacious when it is administered 30 minutes before versus 30 minutes a...

    journal_title:Pediatrics

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1542/peds.2005-0308

    authors: Fitzgerald DA,Hilton J,Jepson B,Smith L

    更新日期:2005-10-01 00:00:00

  • Temperament and regulation of emotion in the first years of life.

    abstract::Temperament is the tendency to express particular emotions with a certain intensity that is unique to each individual child. Although temperament seems to be biologically based, learning to regulate emotional expressions depends on caregiver input and socialization. Part of this process involves forming a trusting rel...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:

    authors: Fox NA

    更新日期:1998-11-01 00:00:00

  • Maternal characteristics and perception of temperament associated with infant TV exposure.

    abstract:OBJECTIVE:This study examines the development of television (TV) behaviors across the first 18 months of life and identifies maternal and infant predictors of infant TV exposure. METHODS:We used longitudinal TV exposure, maternal sociodemographic, and infant temperament data from 217 African-American mother-infant pai...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2012-1224

    authors: Thompson AL,Adair LS,Bentley ME

    更新日期:2013-02-01 00:00:00