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Risk status for dropping out of developmental followup for very low birth weight infants
A T Catlett1, R J Thompson, D A Johndrow
1Duke University Medical Center, Durham, NC 27710.
Insights
Mothers
Area of Science:
- Pediatrics
- Developmental Psychology
- Health Services Research
Background:
- Appointment keeping is crucial for medical care adherence.
- Limited research exists on demographic, biomedical, and psychosocial factors influencing appointment keeping.
- Understanding these factors is vital for pediatric developmental follow-up programs.
Purpose of the Study:
- To investigate the interplay of demographic, biomedical, and psychosocial factors on appointment keeping in a follow-up program for very low birth weight infants.
- To identify predictors of maternal return for infant follow-up visits at 6 and 24 months corrected age.
- To evaluate the effectiveness of transportation provision as an intervention.
Main Methods:
- Longitudinal study design tracking very low birth weight infants and their mothers.
- Analysis of demographic (marital status, race, maternal intelligence), biomedical (gestational age), and psychosocial (stress, coping, social support, efficacy expectations) variables.
- Statistical modeling to identify predictors of appointment keeping and intervention effectiveness.
Main Results:
- Daily living stress significantly predicted maternal return at 6 months corrected age.
- Marital status, race, infant's gestational age, maternal intelligence, and efficacy expectations predicted return at 24 months corrected age.
- Providing transportation successfully reduced dropout rates in a high-risk subgroup.
Conclusions:
- Psychosocial factors, particularly daily living stress, are critical for early follow-up adherence.
- A combination of demographic, biomedical, and psychosocial factors influences long-term follow-up engagement.
- Targeted interventions, like transportation support, can improve adherence for at-risk populations.
Abstract:
Not keeping scheduled visits for medical care is a major health care issue. Little research has addressed how the interaction of demographic and biomedical parameters with psychosocial processes has an impact on appointment keeping. Typical factors are stress of daily living, methods of coping, social support, and instrumental support (that is, tangible assistance). In this study, the authors examine the role of these parameters and processes in the risk status for dropping out of a developmental followup program for very low birth weight infants. The findings suggest that the stress of daily living is a significant predictor for the mother's return when the infant is 6 months of age (corrected for prematurity). The predictors for return at 24 months corrected age include marital status, race, gestational age of the infant, maternal intelligence, and efficacy expectations. Providing transportation was found to be a successful intervention strategy for a subgroup at very high risk for dropping out due to a constellation of biomedical, demographic, and psychosocial factors.