The effect of a parenting education program on the use of preventive pediatric health care services among low-income, minority mothers: a randomized, controlled study.
OBJECTIVE
To determine if a community-based intervention program focusing on parenting education will have an impact on preventive health care utilization behaviors among low-income, minority mothers in Washington, DC.


METHODS
The experimental design was a randomized, controlled study in which 286 mother-infant dyads were assigned to either the standard social services (control) group or to the intervention group. Women and their newborn infants were recruited during the immediate postpartum period in 4 Washington, DC, hospital sites from April 1995 to April 1997. The year-long multicomponent intervention included home visits and hospital-based group sessions in addition to the standard social services available at the hospital sites. A total of 286 postpartum women with inadequate prenatal care were assigned randomly to the control or the intervention group. Women and their infants were followed for 1 full year. Outcome measures included usage of preventive health care services including well care infant visits and adherence to immunization schedules during the first year of the infant's life.


RESULTS
Infants in the intervention group initiated well care at an earlier age than controls (by 6 weeks, 62.5% vs 50% had received their first well infant visit). Infants in the intervention group had more frequent well visits (by 12 months of age, 3.5 vs 2.7 visits). Multivariate analyses showed infants in the intervention group to be more likely to complete their scheduled immunizations (by 9 months, odds ratio = 2.2, 95% confidence interval: 1.09-4.53). Those in the intervention group with more frequent contacts (30+ visits) with study personnel were most likely to have followed age-appropriate immunization schedules when compared with controls (at 9 months odds ratio = 3.63, 95% confidence interval: 1.58-8.33).


CONCLUSIONS
It is possible to influence health care usage patterns of high-risk minority populations through public health interventions that are global in their perspective. Focusing on parental knowledge and beliefs regarding health-related issues and life skills in a self-efficacy model is associated with improved usage of infant health care resources.
El-Mohandes
Ayman A E
AA
Community of Health and Pediatrics/Obstetrics and Gynecology, George Washington University Medical Center, Washington, District of Columbia 20037, USA. sphaxe@gwumc.edu
Katz
Kathy S
KS
El-Khorazaty
M Nabil
MN
McNeely-Johnson
Doris
D
Sharps
Phyllis W
PW
Jarrett
Marian H
MH
Rose
Allison
A
White
Davene M
DM
Young
Michal
M
Grylack
Larry
L
Murray
Kennan D B
KD
Katta
Pragathi S
PS
Burroughs
Melissa
M
Atiyeh
Ghassan
G
Wingrove
Barbara K
BK
Herman
Allen A
AA
D000328:Adult; D001741:Black or African American / Q000193:education; D004219:District of Columbia; D004493:Education / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007115:Immunization Schedule; D009035:Mothers / Q000193:education*; D016487:Parenting; D011203:Poverty / Q000208:ethnology*; D011314:Preventive Health Services / Q000706:statistics & numerical data*