ABSTRACT
Objective
To identify factors associated with participation in group well-child care (GWCC),
wherein families share preventive health care visits.
Methods
We extracted electronic health record data of mother-infant dyads with infants born
2013-2018 at Yale New Haven Hospital and followed at the primary care center. Using
chi-square analysis and multivariate logistic regression, we examined the extent to
which (1) maternal/infant characteristics and recruitment timing were associated with
GWCC initiation and continued engagement and (2) initiation was associated with primary
care visits.
Results
Of 2,046 eligible mother-infant dyads, 11.6% initiated GWCC. The odds of initiation
were higher among mothers with Spanish versus English primary language (OR:2.36 [95%
CI:1.52-3.66]), with 1 child versus >3 children (1.58 [1.13-2.22]), and of non-Hispanic Black versus non-Hispanic White
infants (2.72 [1.39-5.32]). Initiation was lower among infants born in 2016 (0.53
[0.32-0.88]) and 2018 (0.29 [0.17-0.52]) versus 2013. Among GWCC initiators with follow-up
data (n=217), continued engagement (n=132, 60.8%) was positively associated with maternal
age of 20-29 years (2.85 [1.10-7.34]) and >30 years (3.46 [1.15-10.43]) compared with <20 years, and mothers with 1 child versus
≥3 (2.28 [1.04-4.98]). GWCC initiators, versus non-initiators, had 5.06 times higher
adjusted odds of attending >9 primary care appointments in the first 18 months (95% CI:3.74-6.85).
Conclusions
As evidence builds on health and social benefits of GWCC, recruitment efforts may
gain from considering multi-level socio-economic, demographic, and cultural factors
associated with GWCC participation. Higher participation among systemically marginalized
groups may present unique opportunities for family-based health promotion to mitigate
health inequities.
Keywords
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Article info
Publication history
Accepted:
March 10,
2023
Received:
November 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
