Comparing a Team-Based Approach to Standard Well-Child Visits To Improve Preventive Care Services

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age9-15
SponsorSeattle Children's Hospital

About this trial

Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT) is a team-based approach to care that utilizes a community health worker in a health educator role ("Parent's Coach") to provide many of the Well-Child Care (WCC) services that children and families should receive, addresses specific needs faced by families in low-income communities, and decreases reliance on the clinician as the primary provider of WCC services. The model was developed in partnership with clinics and parents in low-income communities and previously tested among largely Latino, Medicaid-insured populations. The aims of this study are to (1) Adapt the PARENT intervention to meet the needs of a diverse, largely Black population of underserved families, (2) Determine the effect of adapted PARENT on receipt of nationally recommended preventive care services, emergency department utilization, and parent experiences of care, (3) Determine whether the effectiveness of adapted PARENT differs by family-level factors, (4) Explore parents' experiences in receiving adapted PARENT, (5) Examine the economic impact of adapted PARENT from the parent stakeholder perspective, (6) Examine the economic impact of adapted PARENT from the pediatric provider and clinic stakeholder perspective, and (7) Examine the economic impact of adapted PARENT on healthcare utilization, from the perspectives of parents and families.

This study will evaluate the effectiveness of the adapted PARENT model as compared to traditional guideline-based WCC and assess the patient-centered economic outcomes of the adapted PARENT model.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

are age ≥9 and ≤15 months on day of data collection,

have ≥1 visit at the practice in previous 9 months

are insured by Partners for Kids, the Accountable Care Organization (ACO) for NCH-PCN

Disqualifiers

N/A

Trial design

Design model

Sequential

Treatments tested in this trial

  • Adapted PARENT Model

    Other intervention

    PARENT is a team-based approach to care that utilizes a clinic-based community health worker as part of the WCC team to provide comprehensive and family-centered preventive care services.

Treatment groups

12 Participants
are divided into 2 treatment groups
Group A: Adapted PARENT ModelExperimental treatment 1 intervention
Group B: Traditional Well-Child CareNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Receipt of preventive care services

Child and parent receipt of three key preventive care services: anticipatory guidance, social needs screening, and structured developmental screening

Time frame
Every 9 months, up to 5 years
2

Healthcare Utilization

Emergency department visits

Time frame
Every 9 months, up to 5 years
3

Parent Experiences of Care

Family-Centeredness Measure

Time frame
Every 9 months, up to 5 years

Secondary outcomes

1

Receipt of additional preventive care services

Receipt of a) social needs referral (e.g., to a food bank), b) successful connection with social needs source (e.g., parent reports accessing food bank), c) developmental or behavioral referral (e.g., Early Intervention Center), and d) successful connection with developmental needs source (e.g., visit at Early Intervention completed).

Time frame
Every 9 months, up to 5 years
2

Other Healthcare Utilization

WCC and acute care visits, and hospitalizations

Time frame
Every 9 months, up to 5 years
3

"At-risk" for developmental delay

Identified as "at-risk" following developmental screening

Time frame
Every 9 months, up to 5 years

Other outcomes

1

Provider-parent visit time

Time stamped number of minutes that provider spent in visit with family

Time frame
Every 9 months, up to 5 years
2

Coach-parent visit time

Time stamped number of minutes that coach spent in visit with family (automated and manual)

Time frame
Every 9 months, up to 5 years
3

Registered Nurse/Medical Assistant (RN/MA)-parent visit time

Time stamped number of minutes that the Registered (RN) or Medical Assistant (MA) spent in visit with family

Time frame
Every 9 months, up to 5 years
4

Total visit time

Time stamped number of minutes family spent at visit (from check in to discharge)

Time frame
Every 9 months, up to 5 years

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Seattle Children's Hospital

Lead sponsor

Hawaii Pacific Health

Sponsor institution

Nationwide Children's Hospital

Collaborator

Patient-Centered Outcomes Research Institute

Collaborator

Hawaii Pacific Health

Collaborator