Well-Child Care Redesign: A New Model of Care for Children in Low-Income Families

NCT02262962 | Completed

• 3 other identifiers: 1R40MC21516K23HD062677R40MC21516
• Study Type: interventional
• Target: 251
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this research is to design and test a new model for delivery of well-child care (WCC) for children ages 0-3 years in a sample of low-income parents. The investigators used an innovative expert panel and community advisory board process to develop this new model for the delivery of WCC to low-income families in partnership with our partner community pediatric practices. The new model of care utilizes a trained health educator, or "Parent Coach" at every well-visit from 0-3 years of age. The Parent Coach provides a range of services, including health education and guidance, developmental screening, and psychosocial screening and services. The Parent Coach works with the Primary Care Physician to ensure that the family's needs are met for that well-visit. As a part of this new model for well-child care, the parent also uses a web-based tool to help prioritize needs for the visit and complete any necessary pre-visit screening. Parents receive additional education and guidance from a text message service and have access to the Parent Coach outside of the visit. The randomized controlled trial (RCT) of this new model of care will include 250 families who will be enrolled at participating clinics if the child is under 1 year of age. Parents will receive the intervention for 12 months and will complete surveys to collect data on their experiences of care. Our hypothesis is that this new model of care will be more patient-centered and more effective in providing recommended preventive care services than usual care, and that it will be a sustainable and feasible model for the partner practices.

Conditions

Preventive Health Services; Health Promotion

Outcome Measures

Primary Outcomes (1)

• Receipt of Recommended Preventive Care Services

  This is a composite measure

  At 12 months post enrollment

Secondary Outcomes (1)

• Receipt of Recommended Preventive Care Services

  At 6 months post enrollment

Study Arms (2)

Usual Well-Child Care

NO INTERVENTION

No change in Well-Child Visits.

Redesigned Well-Child Care

EXPERIMENTAL

The Redesigned Well-Child Visits will be enhanced using a newly-designed model of care. Parents will have access to Parent Coach during child's routine well visits, Well Baby Help Line, Well-Visit Planner, and text messaging services (HealthyTxt).

Other: Redesigned Well-Child Care

Interventions

Redesigned Well-Child Care OTHER

The Well-Child Visits will be enhanced using a newly-designed model of care. Parents will have access to Parent Coach during child's routine well visits, Well Baby Help Line, Well-Visit Planner, and HealthyTxt Messaging service.

Redesigned Well-Child Care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Parent or guardian of an infant who is 12 months of age or younger
• Speaks English or Spanish
• Is 18 years of age or older

You may not qualify if:

• Has plans to move out of Los Angeles county within the next 12 months
• Has plans to change the primary care location for the index child within the next 12 months.
• Parent or guardian is an employee of one of the primary care clinics that are part of the study.

Sponsors & Collaborators

• University of California, Los Angeles: lead
• Health Resources and Services Administration (HRSA): collaborator
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): collaborator

Study Sites (1)

UCLA Children's Discovery and Innovation Institute

Los Angeles, California, 90024, United States

Location

Related Publications (2)

• Coker TR, Moreno C, Shekelle PG, Schuster MA, Chung PJ. Well-child care clinical practice redesign for serving low-income children. Pediatrics. 2014 Jul;134(1):e229-39. doi: 10.1542/peds.2013-3775. Epub 2014 Jun 16.

  PMID: 24936004 BACKGROUND

• Coker TR, Chacon S, Elliott MN, Bruno Y, Chavis T, Biely C, Bethell CD, Contreras S, Mimila NA, Mercado J, Chung PJ. A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial. Pediatrics. 2016 Mar;137(3):e20153013. doi: 10.1542/peds.2015-3013. Epub 2016 Feb 10.

  PMID: 26908675 DERIVED

Study Officials

• Tumaini Coker, MD/MBA

  UCLA Department of General Pediatrics

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: October 3, 2014
• First Posted: October 13, 2014
• Study Start: June 1, 2005
• Primary Completion: January 1, 2015
• Study Completion: January 1, 2015
• Last Updated: June 22, 2016

Record last verified: 2016-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)