predictors of well child care adherence over time in a cohort of urban medicaid-eligible infants预测的儿童保健依从性随着时间的推移,在一群城市medicaid-eligible婴儿.pdfVIP
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predictors of well child care adherence over time in a cohort of urban medicaid-eligible infants预测的儿童保健依从性随着时间的推移,在一群城市medicaid-eligible婴儿
Van Berckelaer et al. BMC Pediatrics 2011, 11:36
/1471-2431/11/36
RESEARCH ARTICLE Open Access
Predictors of well child care adherence over time
in a cohort of urban Medicaid-eligible infants
Anje C Van Berckelaer1,2*, Nandita Mitra3 and Susmita Pati2,3,4
Abstract
Background: Changes in well child care (WCC) adherence over time have not previously been examined. Our
objective is to describe adherence rates to WCC over time in a low-income urban population of infants 0-24
months of age, and to identify predictors of WCC adherence in this population.
Methods: This is a secondary analysis of a cohort of Medicaid-eligible children followed from birth to 2 years
between 2005 and 2008 with structured telephone surveys to assess maternal well-being, social support, and
household and demographic information. For the 260 children attending 4 urban pediatric practices, WCC
adherence was assessed based on visit data abstracted from electronic medical records. A random-intercept mixed
effects logit model clustered on subject was used.
Results: 92% of the mothers were African-American, 27% had not finished high school, 87% were single, and 43%
earned $500/month; mean age was 23. WCC adherence decreased from 88% at 6 months to 47% (12 mo), 44%
(18 mo), and 67% (24 mo). The difference across time periods was statistically significant (p 0.001). Married (OR
1.71, p = 0.02) and primiparous (OR 1.89, p 0.001) mothers had significantly greater odds of adherence, along
with women who reported having been adherent to prenatal care visits (OR 1.49, p = 0.03) and those with the
lowest household income (OR 1.40, p = 0.03).
Conclusions: Maternal education efforts should emphasize the importance of establishing WCC, especially for
mothers of more than one child. Further studies using larger, more broadly defined populations are nee
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