A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial.

Area of Science:

• Pediatrics
• Health Services Research
• Family Medicine

Background:

• Low-income families face barriers to accessing quality well-child care (WCC).
• Existing WCC models may not adequately address the comprehensive needs of vulnerable populations.
• Innovative approaches are needed to improve WCC quality and outcomes.

Purpose of the Study:

• To evaluate the Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT) model.
• To assess the impact of PARENT on WCC quality and healthcare utilization in low-income families.
• To determine if PARENT improves preventive care delivery and reduces costly healthcare services.

Main Methods:

• A randomized controlled trial involving 251 parents and children aged ≤12 months.
• The PARENT intervention included a parent coach, web-based screening, text messages, and brief clinician encounters.
• Outcomes measured included receipt of WCC services, patient experience, and healthcare utilization (ED visits, WCC visits, sick visits) over 12 months.

Main Results:

• Intervention group parents reported higher quality WCC across all preventive care and experience measures.
• Children in the PARENT group had 52% fewer emergency department visits compared to the control group.
• No significant differences were observed in routine WCC or sick visit utilization between groups.

Conclusions:

• A parent coach-led WCC model (PARENT) can enhance the quality of care for low-income families.
• The PARENT model shows potential for reducing emergency department utilization, suggesting cost-saving benefits.
• This model may be effective in improving comprehensive WCC delivery for underserved populations.