Section 4

Many American parents report that health care providers do not regularly provide

Reaching out

information regarding their child's development. In particular, minority or economi 

cally disadvantaged parents are two to four times more likely to express dissatisfac 

to Members

tion with the health care their children receive than white, non poor, insured 

families.

41

A Commonwealth Fund survey found up to 77 percent of parents with 

children from birth to 36 months reported that a health professional had not dis 

cussed one of six age appropriate childrearing topics with them; more than one

third had not discussed any of the topics.

42

Parents who discussed more topics with

their health care provider

were more likely to report

that they received excellent

 Although anticipatory guidance is consid 

care. 

ered an important component of well child

care, the majority of parents reported that

Health plans can empower

they had not discussed most standard top 

parents to play more signifi 

ics with a clinician .  Effort is required to

cant roles in assessing their

provide parents with the information they

child's development. Using

need to take good care of their children. 

43

parents to complete develop 

mental questionnaires may

enhance the accuracy of screening assessments because of the intimate information

parents have about their children. Additionally, health plans can support member

needs by providing materials on childrearing topics, reminders for well child office

visits, and age appropriate developmental milestone materials. Educating families

about what to expect in their child's development and helping families to ask

appropriate questions can also improve communication with providers.

44

Health plans in the BCAP Workgroup on Enhancing Child Development Services in

Medicaid Managed Care employed various member outreach strategies including

mailing materials, offering member incentives, telephone outreach, conducting

home visits, and creating outreach events.  These approaches increased the number

of children who had timely EPSDT visits and the number of children who were for 

mally screened for developmental delay.

41

E.L. Schor.  Rethinking Well Child Care.  Pediatrics 114, no. 1 (2004): 210 16.

42

Commonwealth Fund Survey of Parents with Young Children, as reported by Schuster et al. (2000).

43

M.A. Schuster, N. Duan, M. Regalado and D.J. Klein,  Anticipatory Guidance: What Information Do Parents Receive? What Information Do They Want?  

Archives Pediatric Adolescent Medicine 154 (2000):1191 1198. 

44

C.S. Nelson, L.S. Wissow and T.L. Cheng,  Effectiveness of Anticipatory Guidance: Recent Developments.  Current Opinions in Pediatrics 15 (2003): 

630 635. 

23