This Healthy Tomorrows Partnership for Children Program implemented group well child visits for Asian American immigrant and refugee families and children 0 - 2 years of age. The group visits allowed for caregiver education and support in a culturally competent and financially self-sustainable manner in the context of pediatric medical home.
Implementation Insights:
- Leverage existing opportunities and infrastructure rather than creating completely new initiatives.
- Engage diverse families through cultural brokers who represent culturally and linguistically diverse community members.
- Involve key leaders and stakeholders early to enhance sustainability.
Background Information
Type of Practice: Federally Qualified Health Center
Location: Oakland, California
Population Served: Low-income Asian American immigrant and refugee communities, specifically pregnant women as well as caregivers and children 0-2 years of age. Approximately 120 infants and their caregivers (mostly mothers) have been served by this program since its inception in March 2011.
Pediatric Medical Home Implementation Strategies
- Group 8-10 infants of similar age, culture, and language backgrounds together for a group well child visit, allowing a pediatric clinician to spend up to two hours with a group of families.
- Schedule and implement a series of eight group well child visits over 18 months, based on Bright Futures guidelines.
- Utilize group visits to implement an interactive child development curriculum which educates caregivers on the following issues:
- Child development
- Nurturing and attachment
- Discipline
- Stress management
- Nutrition
- Safety
- Invite culturally and linguistically diverse community health workers from target communities to attend and co-facilitate group well child visits. These individuals can foster a culturally competent environment that enhances collaborative learning, care coordination, and caregiver support.
- Implement team-based, integrated care by supporting on-site case managers and licensed clinical social workers who screen for mental health, toxic stress, and domestic violence among participating families.
- Convene a project advisory board consisting of community and family members; host meetings 2-3 times per year.
- Seek feedback from family and community members by hosting focus groups that are facilitated by community leaders rather than project staff.
- Integrate evaluation components throughout the project to demonstrate project impact and secure funding and support for future endeavors.
- Explore multiple funding sources including the following:
- Healthy Tomorrows Partnership for Children Program
- Every Child Counts
- Universities
- Cultural advocacy organizations
- Title V funded programs
Challenges
- Expanding the project beyond a demonstration to a widely adopted part of regular clinic operations was a challenge. The project utilized evaluation results to demonstrate its impact and enhance leadership buy-in for sustainability. Evaluation results included the following:
- Pre and post surveys were distributed to participating families. Results from the surveys demonstrated increased self-reported social support measures among families; increased utilization of positive discipline approaches; and increased nutritient intake among families and infants.
- Additional evaluation data indicate that 100% of participating families and children had up-to-date immunizations, 100% of mothers were screened for post-partum depression, and 100% of participating infants underwent structured developmental screening and were referred appropriately.
More Information
- For more information, contact Joan Jeung, MD, MS, FAAP, Director, Empowering Mothers Initiative.
- For more information about the Healthy Tomorrows Partnership for Children Program (HTPCP), visit the HTPCP Web site.
Last Updated
06/07/2022
Source
American Academy of Pediatrics