UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif; RAND, Santa Monica, Calif; UCLA Fielding School of Public Health, Los Angeles, Calif.
Acad Pediatr. 2017 Sep-Oct;17(7):747-754. doi: 10.1016/j.acap.2017.02.004. Epub 2017 Feb 14.
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.
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.
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.
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.
以家长为中心的婴幼儿保健计划(PARENT)是一种儿童保健模式,已证明在提高低收入社区 0-3 岁儿童接受全面儿童保健服务的效果和减少急诊利用率方面是有效的。PARENT 依赖健康教育者(“家长教练”)提供儿童保健服务;它使用基于网络的预诊优先排序/筛查工具(就诊计划员)和自动短信提醒/教育服务。我们旨在评估 PARENT 试验干预参与者中的干预可行性和可接受性。
干预组家长在为期 12 个月的研究期间完成了一项调查;邀请其中 26%的随机样本参加定性访谈。使用定性分析的恒比法对访谈进行记录、转录和分析;使用双变量方法分析调查结果。
共有 115 名干预参与者完成了 12 个月的调查;30 名参与者完成了定性访谈。几乎所有的干预参与者都报告说见过教练,觉得她很有帮助,并会推荐继续进行由教练主导的常规健康检查(97-99%)。家长与教练建立了信任关系,认为她是他们儿童保健团队中独特而重要的一员。他们报告说,PARENT 常规健康检查更有效地利用了诊所时间,内容全面且以家庭为中心。大多数人(87%)使用了就诊计划员,并且认为它使用方便(94%);少数人(18%)在就诊前在家里完成了它。62%的人报告使用了短信服务;大多数人认为它是一个有用的新信息来源,也是对就诊期间讨论的信息的强化。
针对儿童保健的以家长为中心的教练干预模式是一种适合低收入城市人群的儿童保健服务提供模式,家长对此模式的接受度和可行性较高。