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Anticipatory Guidance Topics: Are More Better?

  • Shari L. Barkin
    Correspondence
    Address correspondence to Shari Barkin, MD, MSHS, Wake Forest University School of Medicine, Department of Pediatrics, Medical Center Blvd, Winston-Salem, NC 27157
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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  • Benjamin Scheindlin
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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  • Caroline Brown
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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  • Edward Ip
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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  • Stacia Finch
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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  • Richard C. Wasserman
    Affiliations
    From Wake Forest University School of Medicine (Dr Barkin, Ms Brown, and Dr Ip), Winston-Salem, NC; Burlington Pediatrics (Dr Scheindlin), Burlington, Mass; Pediatric Research in Office Settings (Ms Finch and Dr Wasserman), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, Ill; University of Vermont College of Medicine (Dr Wasserman), Burlington, Vt
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      Objective.—Anticipatory guidance is a cornerstone of primary care pediatrics. Despite the fact that retention of information is essential for later action, data are lacking on what parents recall immediately after the visit and 1 month later and how the total number of topics discussed affects this outcome.
      Methods.—Parents and practitioners completed postvisit surveys of anticipatory guidance topics discussed during health-maintenance visits for children ages 2–11. Postvisit and 1 month later, parental recall was compared with provider report of topics discussed. We examined the relationship between parental recall and the total number of topics discussed.
      Results.—Families with children ages 2–11 years from across the United States participated in this study (N = 861). Providers reported discussing the topics of nutrition, car restraints, dental care, and reading aloud most often (72%– 93%). Concordance between parent and provider was high for all topics (72%–90%). Immediately postvisit, parents reported 6.33 (SD 2.9) as the mean number of topics discussed while providers reported 6.9 (SD 2.7) as the mean number of topics discussed. However, parental recall decreased significantly with more topics (≥9) discussed. The same trend existed 1 month later.
      Conclusions.—Providers and parents have good agreement about topics discussed or not discussed during a well-child visit; however, parental recall dwindles with increasing numbers of topics discussed. Rethinking well-child care to limit the total number of topics discussed is warranted.

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