ABSTRACT
OBJECTIVE: To evaluate the timeliness of immunizations of children in CenteringParenting (Centering), a group well-child model, compared to children in individual well-child care. METHODS: We conducted a retrospective cohort study of infants born October 1, 2014 to February 18, 2019 with a 2-month and subsequent well-child visit, both Centering or individual, at an academic pediatric practice in an urban, low-income community. In Centering, same age infants/mothers and a provider meet for 10, 2-hour group visits, and facilitated discussions. Providers are trained in group facilitation and participate in both Centering and individual visits. Primary outcome was timeliness of immunizations at 7, 13, 19, and 25 months. Analyses were by intention to treat. RESULTS: The study population included 1735 children (Centering n = 342, individual n = 1393). By 25 months, 62% of children in Centering were up to date with all recommended immunizations compared to 44.2% of children in individual care, a 17.8% higher rate (P < .001). By 25 months, children in Centering made 3 additional well-child visits (9.2 vs 6.2, P < .001). Mediation analysis showed 82% of the effect on up to date status was due to increased attendance to well-child visits (P < .001); the remaining 18% was due to a Centering effect beyond the visit increase. CONCLUSIONS: Our study showed a strong association of CenteringParenting with timeliness of immunizations and adherence to well-child visits compared to individual visits in a low income community. These findings warrant further exploration of the impact of Centering in reducing health disparities in communities at risk.
Subject(s)
Child Health Services , Immunization , Child , Child Health , Female , Humans , Infant , Poverty , Retrospective StudiesABSTRACT
This study examined the relationships among weight status (BMI), health perceptions, and psychosocial characteristics in children, parents, and parent-child dyads. A convenient sample of 114 parent-child dyads participated. All children were overweight or obese. Parents and children completed questionnaires by self-report or interview. Questionnaires included the Parenting Stress Index-Short Form (PSI), the Parents' Stage of Change (SOC) Questionnaire, and the Pediatric Quality of Life Inventory (PedsQL). Child's mean age was 10.34 years (s.d. = 1.87), mean BMI was 28.13 kg/m(2) (s.d. = 5.46), and mean BMI z-score was 2.17 (s.d. = 0.38). Parent mean age was 37.28 years (s.d. = 12.66) and mean BMI was 34.07 kg/m(2) (s.d. = 8.18). Most parents (68.5%) reported that they and their children (70.7%) were African American and many (44.3%) reported that they and their children were Hispanic. Significant correlations included: child health perceptions and child BMI (r = 0.309, P < 0.001) and parent perception of weight and parent BMI (r = 0.691, P < 0.001). For parent-child dyads, one correlation approached significance (child health perceptions and parent stage of change (r = -0.269, P < 0.01). Findings suggest that characteristics of parent-child dyads may be important considerations in the management of childhood obesity.
Subject(s)
Health Status , Obesity/psychology , Overweight/psychology , Parents/psychology , Self Concept , Adult , Black or African American , Body Mass Index , Child , Female , Health Behavior , Health Surveys , Hispanic or Latino , Humans , Intention , Male , Middle Aged , Motivation , Obesity/ethnology , Overweight/ethnology , Parent-Child Relations , Quality of Life , Surveys and QuestionnairesABSTRACT
BACKGROUND: Disadvantaged children are at high risk for lead poisoning. Their parents often have poor knowledge of lead poisoning and do not know how to prevent lead poisoning in their child. OBJECTIVE: To assess an educational videotape's impact on parental knowledge and behavior about lead poisoning. DESIGN: Prospective study by self-administered parental survey immediately before (pretest) and after (posttest 1) well visits and mailed 2-4 weeks later (posttest 2). The intervention group watched the videotape immediately after the pretest. SETTING: Pediatric clinic in tertiary care hospital. PARTICIPANTS: Consecutive sample of parents of 6-month-old to 6-year-old children (n = 146). MAIN OUTCOME MEASURES: Survey included demographic questions, the shortened Chicago Lead Knowledge Test (sCLKT), and questions about parental behaviors. RESULTS: Mean pretest scores were 5.8 (SD, 2.8) and 5.3 (SD, 2.2), posttest 1 scores were 6.0 (SD, 2.6) and 10.6 (SD, 2.1), and posttest 2 scores were 6.1 (SD, 2.8) and 9.5 (SD, 2.8) of 14 in the control and intervention groups, respectively. Control and intervention group posttest 1 and posttest 2 score differences were statistically significant (P <.05). Intervention group parents reported more frequent washing of their child's hands (P <.05) and windows, walls, or floors at study completion (P <.05). CONCLUSIONS: The videotape significantly increased sCLKT scores and behaviors that may decrease children's risk of developing lead poisoning. Improvement persisted throughout the study period.
