Sabu Stephiya, Simeonsson Kristina, Tumin Dmitry, Buckman Cierra M
Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA -
Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Minerva Pediatr (Torino). 2022 Jun 15. doi: 10.23736/S2724-5276.22.06777-5.
Due to the COVID-19 pandemic, rates of well-child visit (WCV) attendance have significantly decreased. We wanted to see how a parent's positive diagnosis for COVID-19 affected a child's WCV attendance along with other factors. Therefore, we hypothesized that in families with at least 1 positive COVID-19 diagnosis, the rates of WCV attendance would be lower than in families that have not experienced COVID-19.
Using National Health Interview Survey (NHIS) data from 2020, we analyzed sample adult responses for the sample child to questions about last WCV attendance. We included children whose parents completed the survey during quarters 3 and 4 of 2020. The outcome of this study was WCV attendance in the past 12 months with the exposure of interest being parental diagnosis of COVID-19.
In our sample (N=1,413), 91% of children attended a WCV in the past 12 months, and 5% had a parent with a positive COVID-19 diagnosis. On adjusted analysis, there was a negative but not statistically significant association between a parent with a positive COVID-19 diagnosis and WCV attendance (OR=0.32; 95% CI: 0.09, 1.20; p=0.092).
Nationwide, there has been a significant decrease in children attending recommended WCVs since the start of the pandemic. Having a parent test positive for COVID-19 may contribute to decreases in WCV attendance in traditional medical office settings. Alternative options exist that may improve WCV attendance; these include telemedicine or virtual visits, as well as visits completed in non-traditional settings such as mobile health clinics and school-based clinics. Further expansion of these options for WCVs must still take into account health disparities that exist among marginalized communities.
由于新冠疫情，儿童健康检查（WCV）的就诊率显著下降。我们想了解父母新冠病毒检测呈阳性对儿童WCV就诊率以及其他因素有何影响。因此，我们假设在至少有一名家庭成员新冠病毒检测呈阳性的家庭中，WCV就诊率会低于未经历新冠疫情的家庭。
我们使用2020年美国国家健康访谈调查（NHIS）的数据，分析了样本中成年受访者针对样本儿童最近一次WCV就诊情况的回答。我们纳入了其父母在2020年第三和第四季度完成调查的儿童。本研究的结果是过去12个月内的WCV就诊情况，感兴趣的暴露因素是父母的新冠病毒诊断。
在我们的样本（N = 1413）中，91%的儿童在过去12个月内进行了WCV检查，5%的儿童有一位父母新冠病毒检测呈阳性。经调整分析，父母新冠病毒检测呈阳性与WCV就诊率之间存在负相关，但无统计学意义（OR = 0.32；95%CI：0.09，1.20；p = 0.092）。
自疫情开始以来，全国范围内推荐的儿童WCV就诊率显著下降。父母新冠病毒检测呈阳性可能导致传统医疗办公室环境下WCV就诊率降低。存在一些替代选择可能会提高WCV就诊率；这些选择包括远程医疗或虚拟就诊，以及在非传统环境（如移动健康诊所和学校诊所）完成的就诊。WCV这些选择的进一步扩展仍必须考虑边缘化社区中存在的健康差距。
