N/A
N=937
Well-Child Care Clinical Practice Redesign: A Parent Coach-Led Model of Care
Preventive Health Services · Health Promotion
Bottom Line
View on ClinicalTrials.gov: NCT03797898 ↗Enrolled (actual)
937
Serious AEs
0.1%
Results posted
Jun 2023
Primary outcome: Primary: Receipt of Preventive Care Services: Anticipatory Guidance Topics Received by Parent Report at Well Visits — 73.9; 63.3 score on a scale
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Parent Coach (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Seattle Children's Hospital
- Primary completion
- Jul 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Receipt of Preventive Care Services: Anticipatory Guidance Topics Received by Parent Report at Well Visits |
73.9; 63.3 | — |
| PRIMARY Healthcare Utilization: Emergency Department Utilization |
140; 147 | — |
| SECONDARY Clinician Time With Parent During the Well-Child Care (WCC) Visit, From Observations of Well Child Care Visit |
— | — |
| SECONDARY Receipt of Preventive Care Services: Psychosocial Screening Received by Parent Report at Well Visits |
253; 203 | — |
| SECONDARY Receipt of Preventive Care Services: Developmental Concerns Addressed and Screening Received by Parent Report at Well Visits. |
305; 292; 310; 332 | — |
| SECONDARY Healthcare Utilization: Hospitalizations |
12; 9 | — |
| SECONDARY Healthcare Utilization: Well Child Care Visits Up to Date |
309; 295 | — |
| SECONDARY Experiences of Care: Helpfulness of Care Assessment by Parent Report |
77.8; 69.8 | — |
| SECONDARY Experiences of Care: Family Centeredness of Care- Whether it Was Received by Parent Report |
89.0; 85.5 | — |
Summary
Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT) is a team-based approach to care using a health educator ("Parent Coach") to provide the bulk of WCC services, address specific needs faced by families in low-income communities, and decrease reliance on the clinician as the primary provider of WCC services. The Parent Coach provides anticipatory guidance, psychosocial and social needs screening/referral, and developmental and behavioral surveillance, screening, and guidance at each WCC visit, and is supported by parent-focused pre-visit screening and visit prioritization, a brief, problem-focused clinician encounter for a physical exam and any concerns that require a clinician's attention, and an automated text message parent reminder and education service for periodic, age-specific messages to reinforce key health-related information recommended by Bright Futures national guidelines.
The investigators will conduct a cluster RCT of PARENT to determine its effects on quality, utilization, and clinician efficiency, and its cost/cost-offset.
Eligibility Criteria
Inclusion Criteria
- Parent/legal guardian-Child dyad attending well child check-up visits for a 2-week to 12- month WCC visit.
- Parent is English or Spanish proficient
- For multiple gestations, one infant will be randomly selected as the index child. Infants with special health care needs will not be excluded from the study, since these children generally need the same recommended preventive care services.
Exclusion Criteria
- More than one child attending Well-Child Care
- Legal guardian of child is under 18 years of age
- Parents who are employed by one of the federally-qualified health centers (FQHCs)
- Parents/legal guardian not planning to continue receiving well child care services at this clinic for their child in the next 12 months
Data sourced from ClinicalTrials.gov (NCT03797898). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.