title: Well-Child Care Redesign: A Mixed Methods Analysis of Parent Experiences in the PARENT Trial.
abstract: Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), is a well-child care (WCC) model that has demonstrated effectiveness in improving the receipt of comprehensive WCC services and reducing emergency department utilization for children aged 0 to 3 in low-income communities. PARENT relies on a health educator ("parent coach") to provide WCC services; it utilizes a Web-based previsit prioritization/screening tool (Well-Visit Planner) and an automated text message reminder/education service. We sought to assess intervention feasibility and acceptability among PARENT trial intervention participants.
  
  
  
  Intervention parents completed a survey after a 12-month study period; a 26% random sample of them were invited to participate in a qualitative interview. Interviews were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis; survey responses were analyzed using bivariate methods.
  
  
  
  A total of 115 intervention participants completed the 12-month survey; 30 completed a qualitative interview. Nearly all intervention participants reported meeting with the coach, found her helpful, and would recommend continuing coach-led well visits (97-99%). Parents built trusting relationships with the coach and viewed her as a distinct and important part of their WCC team. They reported that PARENT well visits more efficiently used in-clinic time and were comprehensive and family centered. Most used the Well-Visit Planner (87%), and found it easy to use (94%); a minority completed it at home before the visit (18%). Sixty-two percent reported using the text message service; most reported it as a helpful source of new information and a reinforcement of information discussed during visits.
  
  
  
  A parent coach-led intervention for WCC for young children is a model of WCC delivery that is both acceptable and feasible to parents in a low-income urban population.
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Mimila
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif; RAND, Santa Monica, Calif; UCLA Fielding School of Public Health, Los Angeles, Calif.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Chung
authors.affiliation: RAND, Santa Monica, Calif.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Bethell
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
authors.forename: Sandra
authors.initials: S
authors.lastname: Chacon
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
authors.forename: Christopher
authors.initials: C
authors.lastname: Biely
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
authors.forename: Sandra
authors.initials: S
authors.lastname: Contreras
authors.affiliation: Wee Care Associates, Compton, Calif.
authors.forename: Toni
authors.initials: T
authors.lastname: Chavis
authors.affiliation: YBPC, Duarte, Calif.
authors.forename: Yovana
authors.initials: Y
authors.lastname: Bruno
authors.affiliation: UCLA Children's Discovery and Innovation Institute, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
authors.forename: Tanesha
authors.initials: T
authors.lastname: Moss
authors.affiliation: University of Washington, and Seattle Children's Research Institute, Seattle, WA. Electronic address: Tumaini.Coker@seattlechildrens.org.
authors.forename: Tumaini R
authors.initials: TR
authors.lastname: Coker
mesh_terms: D001741:Black or African American; D001294:Attitude to Health / Q000208:ethnology; D000067576:Child Health; D002662:Child Health Services; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology*; D011203:Poverty; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D060145:Text Messaging; D014505:Urban Population
keywords: practice redesign; preventive care; randomized controlled trial; well-child care