HEALTH SUPERVISION FOR INFANTS AND TODDLERS: DO PARENTS AND PEDIATRICIANS AGREE? Lynn M. Olson, Neal Halfon, Karen O'Connor, Moira Inkelas Practice & Research, American Academy of Pediatrics, Elk Grove Village, IL; Ctr for Healthier Children, Families, Communities, ULCA, Los Angeles

BACKGROUND: Health supervision visits for preschoolers are core to pediatric primary care. Despite the central role of these visits, little is known about the match between parents' and pediatricians' views regarding health supervision.

OBJECTIVE: Describe and compare parents' and pediatricians' views of health supervision for children < 3 yrs on: a) length of visit, b) content of care, and c) gaps between what parents want to discuss and what is addressed.

DESIGN/METHODS: Telephone survey of parents of children 4-35 months, National Survey of Early Childhood Health (NSECH) (year = 2000, n = 2,068). Data were weighted to represent all US preschoolers, including an adjustment for non-telephone households. National random sample, mailed Periodic Survey of AAP members (year = 2000, n = 811). For parents content of care reported as average % discussing topic; for pediatricians content of care reported as percent who discuss topic with > 75% of parents.

RESULTS: Eighty-five percent of parents say health supervision visits are "very important" to the health and development of their child. Parents report that their child's health care provider spends an average of 17.7 minutes (SE = .33) in a typical visit; 87% say this amount of time is "about right." Pediatricians report spending an average of 18.3 minutes (SE = .23) with the patient; 79% say this amount of time is "about right." For children 10-18 months, the percentage of parents and pediatricians who report discussing specified topics (respectively) are: immunizations (98 vs 93), food/feeding issues (93 vs 91), car seats (77 vs 73), vocabulary development (69 vs 80), night waking/fussing (67 vs 52), sleeping w/bottle (64 vs 69), reading (63 vs 55), weaning from bottle (53 vs 73), syrup of Ipecac (46 vs 38), discipline (43 vs 64), child care (35 vs 43), and toilet training (17 vs 47). The largest gaps between what parents report receiving and what they would have liked to discuss are in the areas of: toilet training, discipline, injury prevention, child care, and reading. Reported discussion of specific topics varies by several family characteristics.

CONCLUSIONS: Parents rank health supervision visits as very important and feel the visits are of adequate length. Parents and pediatricians report generally high concordance on issues discussed; parents, however, note several areas where they need more information.