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Published on: August 1, 2019
Differences in pediatric preventive care counseling by provider type
Cynthia D Perry1, Genevieve M Kenney
1The Urban Institute, Washington, DC 20037, USA. cperry@ui.urban.org
Insights
Pediatricians are more likely to advise children on health behaviors and injury prevention than other providers. However, overall rates of advice remain low, indicating missed opportunities for pediatric care.
Area of Science:
- Pediatric Health
- Preventive Care
- Health Behavior Counseling
Background:
- Many children in the U.S. do not receive essential health and safety advice during routine check-ups.
- This gap in preventive care highlights a need to understand factors influencing advice delivery.
Purpose of the Study:
- To investigate how provider type impacts the likelihood of children receiving health behavior and injury prevention advice.
- To identify specific areas of advice delivery influenced by provider specialization.
Main Methods:
- Analysis of children aged 3-17 from the Medical Expenditure Panel Data (2002-2003).
- Focus on children with a single preventive visit in the past year.
- Examination of advice given on healthy eating, physical activity, smoking risks, car safety, and helmet use based on provider type.
Main Results:
- Pediatricians were significantly more likely to provide advice on healthy eating, exercise, smoking risks, car safety, and helmet use compared to other physicians and non-physicians.
- Despite higher rates from pediatricians, overall advice delivery across all provider types was low.
Conclusions:
- Pediatricians are more effective in delivering health and safety advice, but opportunities are missed, especially by non-pediatrician providers.
- There is a critical need to improve the consistency and comprehensiveness of health behavior and injury prevention counseling in pediatric preventive care.
Objective:
Many children in the United States do not receive advice about health behaviors and injury prevention during routine preventive care visits. We investigated the role of provider type in the probability of receiving advice.
Methods:
We analyzed children aged 3 to 17 in the Medical Expenditure Panel Data 2002 to 2003 surveys who had only 1 preventive clinic or office visit in the past year. We examined whether provider type affects whether the child is advised about healthy eating, physical activity, the harmful effects of smoking in the home, proper safety restraints in a car, and use of a helmet when riding a bicycle.
Results:
Pediatricians were more likely to advise about healthy eating (63.6% vs 46.8% for other physicians and 41.1% for nonphysicians; P < .01). They were also more likely than nonphysicians to advise about exercise (40.1% vs 22.2%), the harmful effects of parental smoking (42.4% vs 21.4%), proper safety restraints in a car (39.9% vs 20.5%), and use of a bicycle helmet (45.7% vs 20.9%). Regardless of provider type, rates of advice were low.
Conclusion:
Many pediatric providers, particularly those not trained as pediatricians, are missing opportunities to advise about health behaviors and injury prevention.
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