Child Health Equity Center Core Faculty members Arvin Garg, MD, MPH, and Alison LeBlanc, MS, PMP, recently co-authored with colleagues an article that promotes adherence to well-child visits within the UMass Memorial Health safety-net healthcare system. This project was the first recipient of the Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity.
Childhood experiences affect adult health either through cumulative damage or biological embedding of adversities. Adversity and distress in childhood can be caused by factors that create inequitable living environments, toxic exposures, and social circumstances. These social determinants of health can be addressed early in childhood to decrease detrimental health outcomes.
A UMass Memorial team discovered racial and ethnic disparities in adherence to well-child visits. Well-Child Care (WCC) visits promote the health, development, and well-being of a child. Adherence to WCC visits gives the healthcare team an opportunity to address both the health and social needs of the child. If Black and Latinx children have lower adherence, the opportunities for their physical and social needs to be met decreases and can lead to further healthcare inequity.
To address adherence disparities in WCC visits, caregivers were interviewed to identify the barriers that negatively affected their situations. Transportation, language, and scheduling were identified as key barriers. A multidisciplinary team implemented the following strategies to address the key barriers:
- WCC visits were conducted during acute care appointments. This saved caregivers a drive back to a hospital. It also served to address any social needs that might have led to the acute care being necessary.
- Individual dashboards with review performance by race, ethnicity, and language were given to each practice. The real-time feedback allowed for improved, tailored interventions.
- A workflow for transportation requests was made to facilitate requests, tip sheets for interpreter access were given to providers, and a protocol for appointment reminders was created with an outside vendor.
Implementation of these strategies successfully improved WCC visit adherence among Black-identifying patients from 58.7% to 71.9% and from 64.3% to 74.1% in Latinx-identifying patients.
WCC visits are an important component of our work to identify health care disparities to promote child health equity.
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About the Author
Katherine Barahona Paz, BS, is a Research Coordinator at the Child Health Equity Center who focuses primarily on WE CARE studies. She is a recent graduate of Boston University.