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Continuous Source of Care Among Young Underserved Children: Associated Characteristics and Use of Recommended Parenting Practices

  • Esther K. Chung
    Correspondence
    Address correspondence to Esther K. Chung, MD, MPH, Associate Professor of Pediatrics, Jefferson Pediatrics/duPont Children's Health Program, 833 Chestnut Street, Suite 300, Philadelphia, Pennsylvania 19107.
    Affiliations
    From the Department of Pediatrics, the Alfred I. duPont Hospital for Children, Wilmington, Del (Dr Chung); Jefferson Medical College, Philadelphia, Pa (Dr Chung); the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa (Ms McCollum, Mr Mathew, and Dr Culhane); and the Department of Sociology, University of Pennsylvania, Philadelphia, Pa (Dr Elo)
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  • Leny Mathew
    Affiliations
    From the Department of Pediatrics, the Alfred I. duPont Hospital for Children, Wilmington, Del (Dr Chung); Jefferson Medical College, Philadelphia, Pa (Dr Chung); the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa (Ms McCollum, Mr Mathew, and Dr Culhane); and the Department of Sociology, University of Pennsylvania, Philadelphia, Pa (Dr Elo)
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  • Kelly F. McCollum
    Affiliations
    From the Department of Pediatrics, the Alfred I. duPont Hospital for Children, Wilmington, Del (Dr Chung); Jefferson Medical College, Philadelphia, Pa (Dr Chung); the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa (Ms McCollum, Mr Mathew, and Dr Culhane); and the Department of Sociology, University of Pennsylvania, Philadelphia, Pa (Dr Elo)
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  • Irma T. Elo
    Affiliations
    From the Department of Pediatrics, the Alfred I. duPont Hospital for Children, Wilmington, Del (Dr Chung); Jefferson Medical College, Philadelphia, Pa (Dr Chung); the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa (Ms McCollum, Mr Mathew, and Dr Culhane); and the Department of Sociology, University of Pennsylvania, Philadelphia, Pa (Dr Elo)
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  • Jennifer F. Culhane
    Affiliations
    From the Department of Pediatrics, the Alfred I. duPont Hospital for Children, Wilmington, Del (Dr Chung); Jefferson Medical College, Philadelphia, Pa (Dr Chung); the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa (Ms McCollum, Mr Mathew, and Dr Culhane); and the Department of Sociology, University of Pennsylvania, Philadelphia, Pa (Dr Elo)
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      Objectives

      The aim of this study was to 1) assess sociodemographic and health characteristics associated with having a continuous source of care (CSOC) among young children and 2) determine the relationship between having a CSOC and use of parenting practices.

      Methods

      We conducted a prospective, community-based survey of women receiving prenatal care at Philadelphia community health centers. We conducted surveys at the first prenatal visit and at a mean age ± standard deviation of 3 ±1, 11 ± 1, and 24 ± 2 months postpartum, obtaining information on sociodemographic and health characteristics, child's health care provider, and 6 parenting practices. Group differences were tested between those with and without a CSOC by using the chi-square test for categorical variables and the Student's t test for continuous variables. Logistic regression analysis was conducted to adjust for potential confounding variables.

      Results

      Our sample consisted of 894 mostly young, African American, single women and their children. In the adjusted analysis, mothers of children with a CSOC, when compared with those without a CSOC, were more likely to have a high school education or less, be born in the United States, have a postpartum checkup, have stable child health insurance, and initiate care for their child at a site other than a community-based health center. Use of parenting practices was similar for children with and without a CSOC.

      Conclusions

      Maternal nativity, postpartum care, child health insurance, and initial site of infant care were associated with CSOC, but infant health characteristics were not. Use of parenting practices did not differ for those with and without a CSOC.

      Key Words

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