Advanced Health Information Technologies to Engage Parents, Clinicians, and Community Nutritionists in Coordinating Responsive Parenting Care: Descriptive Case Series of the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care Randomized Controlled Trial

Advanced Health Information Technologies to Engage Parents, Clinicians, and Community Nutritionists in Coordinating Responsive Parenting Care: Descriptive Case Series of the Women, Infants, and Children Enhancements to Early Healthy Lifestyles for Baby (WEE Baby) Care Randomized Controlled Trial

Socioeconomically disadvantaged newborns receive care from primary care providers (PCPs) and Women, Infants, and Children (WIC) nutritionists. However, care is not coordinated between these settings, which can result in conflicting messages. Stakeholders support an integrated approach that coordinat...

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Bibliographic Details
Published in:JMIR pediatrics and parenting Vol. 3; no. 2; p. e22121
Main Authors: Kling, Samantha Mr, Harris, Holly A, Marini, Michele, Cook, Adam, Hess, Lindsey B, Lutcher, Shawnee, Mowery, Jacob, Bell, Scott, Hassink, Sandra, Hayward, Shannon B, Johnson, Greg, Franceschelli Hosterman, Jennifer, Paul, Ian M, Seiler, Christopher, Sword, Shirley, Savage, Jennifer S, Bailey-Davis, Lisa
Format: Journal Article
Language:English
Published: Canada JMIR Publications 24-11-2020
Subjects:
Babies
Children & youth
Continuity of care
Documentation
Electronic health records
Enrollments
Health behavior
Health care
Information sharing
Lifestyles
Medical personnel
Mothers
Newborn babies
Nutritionists
Obesity
Original Paper
Parents & parenting
Patient-centered care
Pediatrics
Primary care
Public health
Risk assessment
Usability
Web portals
Womens health
United States > US
Pennsylvania
pragmatic intervention
clinical care
responsive parenting
coordination of care
health information technology
data sharing
early obesity prevention
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Summary:Socioeconomically disadvantaged newborns receive care from primary care providers (PCPs) and Women, Infants, and Children (WIC) nutritionists. However, care is not coordinated between these settings, which can result in conflicting messages. Stakeholders support an integrated approach that coordinates services between settings with care tailored to patient-centered needs. This analysis describes the usability of advanced health information technologies aiming to engage parents in self-reporting parenting practices, integrate data into electronic health records to inform and facilitate documentation of provided responsive parenting (RP) care, and share data between settings to create opportunities to coordinate care between PCPs and WIC nutritionists. Parents and newborns (dyads) who were eligible for WIC care and received pediatric care in a single health system were recruited and randomized to a RP intervention or control group. For the 6-month intervention, electronic systems were created to facilitate documentation, data sharing, and coordination of provided RP care. Prior to PCP visits, parents were prompted to respond to the Early Healthy Lifestyles (EHL) self-assessment tool to capture current RP practices. Responses were integrated into the electronic health record and shared with WIC. Documentation of RP care and an 80-character, free-text comment were shared between WIC and PCPs. A care coordination opportunity existed when the dyad attended a WIC visit and these data were available from the PCP, and vice versa. Care coordination was demonstrated when WIC or PCPs interacted with data and documented RP care provided at the visit. Dyads (N=131) attended 459 PCP (3.5, SD 1.0 per dyad) and 296 WIC (2.3, SD 1.0 per dyad) visits. Parents completed the EHL tool prior to 53.2% (244/459) of PCP visits (1.9, SD 1.2 per dyad), PCPs documented provided RP care at 35.3% (162/459) of visits, and data were shared with WIC following 100% (459/459) of PCP visits. A WIC visit followed a PCP visit 50.3% (231/459) of the time; thus, there were 1.8 (SD 0.8 per dyad) PCP to WIC care coordination opportunities. WIC coordinated care by documenting RP care at 66.7% (154/231) of opportunities (1.2, SD 0.9 per dyad). WIC visits were followed by a PCP visit 58.9% (116/197) of the time; thus, there were 0.9 (SD 0.8 per dyad) WIC to PCP care coordination opportunities. PCPs coordinated care by documenting RP care at 44.0% (51/116) of opportunities (0.4, SD 0.6 per dyad). Results support the usability of advanced health information technology strategies to collect patient-reported data and share these data between multiple providers. Although PCPs and WIC shared data, WIC nutritionists were more likely to use data and document RP care to coordinate care than PCPs. Variability in timing, sequence, and frequency of visits underscores the need for flexibility in pragmatic studies. ClinicalTrials.gov NCT03482908; https://clinicaltrials.gov/ct2/show/NCT03482908. RR2-10.1186/s12887-018-1263-z.
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ISSN:2561-6722
2561-6722
DOI:10.2196/22121