Delays in Children’s Preventive Health Services During the COVID-19 Pandemic

Abstract

Background and Objectives: Stay-at-home orders, social isolation recommendations, and fear of COVID-19 exposure have led to delays in children’s preventive health services during the pandemic. Delays can lead to missed opportunities for early screening and detection of health problems, and increased risks for outbreaks of vaccine-preventable diseases. Understanding prevalence of and reasons for missed, delayed, or skipped preventive health services is important for developing strategies to achieve rapid catch-up of essential health services. Methods: Using the Household Pulse Survey (n=37,064), a large, nationally-representative household survey fielded from April 14 to May 10, 2021, we examined prevalence of households with children who have missed, delayed, or skipped preventive health services, and factors associated with and reasons contributing to missed, delayed, or skipped preventive health services. Results: About one-quarter of parents had children who missed, delayed, or skipped preventive check-ups in the past year. Delays in children’s preventive health services were more common among respondents with higher education, households with greater numbers of children, and children who learned remotely or did not participate in formal education. Main reasons attributed to delayed preventive health services were limited appointments at health providers’ offices (42.9%), concern about COVID-19 exposure at health providers’ offices (42.2%), and closed health providers’ offices due to the pandemic (29.0%). Conclusions: Physician office closures and concern about COVID-19 exposure resulted in over one-quarter of parents delaying preventive services for their children since the pandemic began. Coordinated efforts are needed to achieve rapid catch-up of preventive services and routine vaccines.

Racial and Ethnic Differences in Factors Associated With Delayed or Missed Pediatric Preventive Care in the US Due to the COVID-19 Pandemic

“…The results of this study suggest that 27.6% of US children aged 0 to 17 years had delayed or missed preventive care due to the COVID-19 pandemic, which is consistent with the limited available research in this area. [3][4][5] We observed that several predisposing, enabling, and need factors were associated with delayed or missed pediatric preventive care, with differences by racial and ethnic group.…”

“…[9][10][11][12][13][14][15][16][17] Studies examining the prevalence of delayed or missed pediatric preventive care during the COVID-19 pandemic in a nationwide sample of US children are scarce, and only a few have explored potential determinants. 4,5 Such studies did not examine potential risk factors such as child age, main caregiver physical or mental health, home ownership, having a usual source of pediatric preventive care, having a personal doctor or nurse, perceived child health, and evaluated child health, 4,5 which may have resulted in residual confounding, because such factors may affect health care access and use. 18,19 Further, previous studies 4,5 did not examine associations by child racial and ethnic group, which may have precluded the identification of race and ethnicity-specific risk and protective factors for delayed or missed pediatric preventive care.…”

“…Studies examining the prevalence of delayed or missed pediatric preventive care during the COVID-19 pandemic in a nationwide sample of US children are scarce, and only a few have explored potential determinants . Such studies did not examine potential risk factors such as child age, main caregiver physical or mental health, home ownership, having a usual source of pediatric preventive care, having a personal doctor or nurse, perceived child health, and evaluated child health, which may have resulted in residual confounding, because such factors may affect health care access and use .…”

“…It is possible that the latter may experience barriers to care that were not examined in this study, such as transportation challenges, limited appointment availability in the area, or long waiting times 20. In previous research, the most frequently reported reasons for delayed or missed pediatric preventive care included fear of COVID-19 exposure, reported among Asian, Black, and White individuals; limited appointments, reported among Hispanic, White, and multiracial individuals; and clinics being closed, reported among Black and Hispanic individuals; no such studies examined American Indian or Alaska Native individuals separately 5,6. finding that more than one-fourth of US children experienced delayed or missed preventive care due to the COVID-19 pandemic highlights the need for targeted outreach efforts to promote catch-up visits, particularly among high-risk groups, including Asian or Pacific Islander, Hispanic, and multiracial children.…”

Perceptions of Healthcare Providers and Caregivers Regarding Procedures for Early Detection of Developmental Delays in Infants and Toddlers in Saudi Arabia

“…Finally, this study was conducted between 2021 and 2022 during the COVID-19 pandemic. According to Nguyen et al (2022), the pandemic affected the number of well-child visits, with one-quarter of parents delaying or canceling their appointments [ 38 ]. Thus, these conditions may have affected the number of well-child visits in the present study.…”