Parent coach Sandra Contreras, left, chats with a mom during a PARENT well-child visit. PHOTO COURTESY UCLA
Before they turn 3, kids are supposed to have 10 well-child visits with a pediatrician (apart from those inevitable visits for childhood illnesses). These should offer a chance to address the many questions parents of young children face, but time with the pediatrician is often less than 15 minutes – hardly enough time to cover even the basics.
To make the most of that time, be prepared. Before your child’s next visit, write down the three most important questions you want to ask and bring those to the pediatrician’s attention as soon as she or he enters the exam room, “so that those don’t get left behind,” advises Tumaini Rucker Coker, M.D., associate director of health services research at the UCLA Children’s Discovery and Innovation Institute.
There’s even an online tool that can help. The Well Visit Planner (www.wellvisitplanner.org) has parents spend about 15 minutes answering a series of questions about their child and family, then choosing a few priorities to discuss with the pediatrician. They then receive a customized, printable “visit guide” highlighting their priorities and other topics – based on the information provided – that might be important to discuss with the doctor.
Coker recently led a clinical trial that used the tool as part of a new model for well-child visits called “Parent-focused Redesign for Encounters, Newborns to Toddlers” (or PARENT). During PARENT well-child visits, a “parent coach” uses the planner to zero in on a family’s needs. Time with the parent coach takes place after families are called from the waiting room to the exam room, time they would normally spend waiting for the doctor to arrive. “That’s a 20-minute period of time that the parent has to talk about the issues that are impacting them as a parent,” Coker says. The doctor then comes in to finish the visit.
“My main focus was helping the parents get what they wanted from the well-child visit,” says Sandra Contreras, one of the coaches trained for the program. Contreras says parents’ questions ranged from toilet training and nutrition to family issues such as depression and financial issues. In some cases, she connected families with community resources. In others, she worked with the pediatrician to see that concerns were addressed.
During the year the model was studied in two clinics in Duarte and Compton, 251 families took part. Families in the group that had PARENT well-child visits were more likely to report receiving the guidance and screenings they needed, and that their concerns about their child’s health and behavior were addressed. Children in the PARENT group also had significantly fewer visits to the emergency department.
While these families were in low-income communities, Coker believes PARENT could be helpful for all parents. “I have three kids myself, twin boys and a baby girl,” she says. “When the twins were born I was already a pediatrician, but I had so many questions.” Coker and her team will now expand their research to 12-15 area clinics. And one day, PARENT well-child visits could be coming to a doctor’s office near you.
