Grant Application

Debra Bogen, MD, Kristin Hannibal , MD, Stacey Cook, MD, PhD, Janice Frye, Bethany Blackburn, Gabriela Algarroba, and Heather Joseph, MD,Children’s Hospital of Pittsburgh of UPMC Primary Care Center-Oakland

Proposed Innovation

Well child care (WCC) visits are an essential element of pediatric primary care in the United States. According to the Bright Futures Guidelines established by the American Academy of Pediatrics, these visits provide an opportunity for pediatricians to obtain a medical history, perform a physical examination, and identify and address developmental, behavioral, social, health, and other issues. However, it has proven challenging for pediatricians to provide the recommended comprehensive care, particularly in the typical 15-minute timeframe allotted for families.

The goal of this project is to develop, pilot, and evaluate a Group Well Child Care (GWCC) program at the Children’s Hospital of Pittsburgh Primary Care Center-Oakland that incorporates parent-child interaction and parent engagement.

Improvements in Action

The pilot GWCC will enroll 6 to 8 groups of infant-parent dyads over a year. The groups, which will be based on birth date, will meet for 90-minute visits at 1, 2, 4, 6, 9, and 12 months of age as recommended by the Bright Futures Guidelines. Parents will be given a Personal Child Health Record to record and track their child’s growth, development, immunization, and health information, along with their hopes and reflections of their child. Photographs of the infant-parent dyad taken at each visit will be included in the booklet. After all infants are measured and examined, group discussion will begin with an “opener activity,” followed by interactive discussions on child growth, feeding, development, behavior, parent-child play and interaction, safety and parental concerns, questions, and hopes and dreams.

Results – In Progress

The GWCC program will be modified based on feedback gathered from parents following each visit. The program will be evaluated by comparing reports by parents who participate in group versus individual WCC with regards to parent satisfaction, knowledge of child development, actual child development and behavior, and parental well-being and confidence. Medical records also will be reviewed to compare outcomes in child development, sleep, adherence to infant feeding recommendations, well child care, and immunizations, and the number of sick visits, urgent and emergency care visits, and hospitalizations.