Child Health Measurement Project

Rethinking Child Health Supervision (RCHS)

Health supervision and well-child visits are a core component of general pediatric care. Nearly every child in the United States under the age of 3 receives some well-child care, and pediatricians are the primary health care providers for this age group. Through these visits, pediatricians play an important role in identifying potential problems and helping families promote their children's healthy development. Increasingly, pediatricians are asked to address not only traditional issues such as immunizations and physical growth but also developmental needs and psychosocial issues of the family. Professional resources such as AAP Guidelines for Health Supervision III and Bright Futures point to the importance of anticipatory guidance for child health and development.

The 2000 National Survey of Early Childhood (NSECH) provides a detailed account of what pediatricians are providing and the degree to which they are fulfilling parent needs during well-child visits with young children. According to NSECH, most parents -86%-believe well-child visits are very important for their child's health and development. Parents indicated that the areas of greatest unmet need were primarily those related to developmental and behavioral issues.

With funding from The Commonwealth Fund in 2005, we obtained expert professional and parent opinion regarding the timing, processes and content priorities for child health supervision to address the most important developmental needs of children and families. Using qualitative methodology, we collected data via open-ended interviews and focus groups. Study participants included primary care practitioners (private, community, and academic), developmental-behavioral pediatricians, pediatric nurses, family practitioners, child and family development experts, developmental psychologists, and parents.

Anticipated outcomes of the project included:

• New availability of professional and parental opinion with which to consider changes in the guidelines, funding, and training connected with well-child care
• An increase in awareness, among clinicians, academicians, and professional leaders, regarding the opportunities for enhancing the development of children
• A body of expert and parent opinion that may be specifically utilized in the development of future health care guidelines

Data collection is now complete and an article, Well-Child Care: Looking Back, Looking Forward has been published in Pediatric Annals. Other manuscript development is currently underway. We have also made a number of presentations at scientific meetings in order to disseminate knowledge about the project.

Project director: J. Lane Tanner, MD, FAAP, Children's Hospital & Research Center at Oakland
Co-Investigators: Martin T. Stein, MD, FAAP, University of California at San Diego & Lynn M. Olson, PhD, American Academy of Pediatrics
Project period: 6/1/2005-5/31/2007

For more information about the Rethinking Child Health Supervision Project, please contact:

Senior Research Associate - Child Health Measurement Project
Department of Research
American Academy of Pediatrics
141 Northwest Point Blvd
Elk Grove Village, IL 60007

Or send an e-mail to Senior Research Associate at dorchmp@aap.org

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