Pediatric Practice Redesign with Group Well Child Care Visits: A Multi-Site Study

Friedman, Sara L.; Calderon, Bianca; Gonzalez, Amanda; Suruki, Caitlyn; Blanchard, Ashley; Cahill, Erin; Kester, Kristen; Muna, Martha; Elbel, Erin E.; Purushothaman, Priya; Krause, Margaret C.; Meyer, Dodi

doi:10.1007/s10995-021-03146-y

Cited by 8 publications

(17 citation statements)

References 22 publications

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“…GWCC was often implemented in response to health system constraints in traditional care (e.g., lack of time, limited opportunities to address psychosocial topics) and to more efficiently address family needs (Anderson, 2006 ; Bloomfield & Rising, 2013 ; Friedman et al, 2021 ; McNeil et al, 2016 ; Osborn, 1982 ; Page et al, 2010 ; Stein, 1977 ). Most of the GWCC literature describes it being implemented in underserved patient populations (Gaskin et al, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the GWCC literature describes it being implemented in underserved patient populations (Gaskin et al, 2021 ). Several studies reported that implementation of GWCC was aimed at addressing specific stressors more effectively (e.g., low health literacy, unmet social needs) or to deliver care to a particular population (e.g., children in immigrant families) (Bloomfield & Rising, 2013 ; Friedman et al, 2021 ; Platt et al, 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…Across clinic settings, studies underscored the importance of program champions, staff and administrative buy-in, and institutional leadership for sustaining GWCC—through advocating for and committing resources to its continuation (Bloomfield & Rising, 2013 ; Friedman et al, 2021 ; MacMillan Uribe et al, 2019 ; McNeil et al, 2016 ; Novick et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most GWCC models bring together the same group of 6–8 parents and their infants, who are born within one month of one another, for one to 2 years of preventive care visits (Bloomfield & Rising, 2013 ; Gaskin et al, 2021 ). In general, sessions are 120 min with the first 30–45 min consisting of standard health assessments of the infant and caregiver, by a clinician in a semi-private section of the room, followed by 75–90 min of group discussion using interactive health promotion activities (Bialostozky et al, 2016 ; Connor et al, 2017 ; DeLago et al, 2018 ; Friedman et al, 2021 ; Marchel et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

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A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research

Gresh

Wilson

Fenick

et al. 2023

Matern Child Health J

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Objective To use scoping review methods to construct a conceptual framework based on current evidence of group wellchild care to guide future practice and research. Methods We conducted a scoping review using Arksey and O'Malley's (2005) six stages. We used constructs from the Consolidated Framework for Implementation Research and the quadruple aim of health care improvement to guide the construction of the conceptual framework. ResultsThe resulting conceptual framework is a synthesis of the key concepts of group well-child care, beginning with a call for a system redesign of well-child care to improve outcomes while acknowledging the theoretical antecedents structuring the rationale that supports the model. Inputs of group well-child care include health systems contexts; administration/ logistics; clinical setting; group care clinic team; community/patient population; and curriculum development and training. The core components of group well-child care included structure (e.g., group size, facilitators), content (e.g., health assessments, service linkages). and process (e.g., interactive learning and community building). We found clinical outcomes in all four dimensions of the quadruple aim of healthcare. Conclusion Our conceptual framework can guide model implementation and identifies several outcomes that can be used to harmonize model evaluation and research. Future research and practice can use the conceptual framework as a tool to standardize model implementation and evaluation and generate evidence to inform future healthcare policy and practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research

Gresh

Wilson

Fenick

et al. 2023

Matern Child Health J

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“…Fidelity scores varied across domains and clinics, the environment and logistics conducive for group care was the most challenging, and delity to community building and group dynamics was consistently high across clinics. Studies of group well-child care highlight the importance of community building and group dynamics in the postpartum period as it has been shown to foster partnerships between families, clinicians, and communities and is a key component in addressing health related social needs (11,(32)(33)(34). Clinic C demonstrated the highest model delity score as well as has the highest ratings of acceptability, appropriateness, and feasibility.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of implementation outcomes of an integrated group postpartum and well-child care model at clinics in Malawi

Gresh

Mambulasa

Ngutwa

et al. 2023

Preprint

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Background Persistently elevated rates of maternal and infant mortality and morbidities in Malawi indicate the need for increased quality of maternal and well-child care services. The first-year postpartum sets the stage for long-term health for the childbearing parent and infant. Integrated group postpartum and well-child care may improve maternal and infant health outcomes. The purpose of this study was to examine implementation outcomes for this model of care. Methods We used mixed methods to examine implementation outcomes of integrated group postpartum and well-child care. We piloted sessions at three clinics in Blantyre District, Malawi. During each session we evaluated fidelity using a structured observation checklist. At the end of each session, we administered three surveys to health care workers and women participants, the Acceptability of Intervention Measure, the Intervention Appropriateness Measure, and the Feasibility of Intervention Measure. Focus groups were conducted to gain greater understanding of people’s experience with and evaluation of the model. Results Forty-one women with their infants participated in group sessions. Nineteen health care workers across the three clinics co-facilitated group sessions, 9 midwives and 10 health surveillance assistants. Each of the 6 sessions was tested once at each clinic for a total of 18 pilot sessions. Both women and health care workers reported group postpartum and well-child care was highly acceptable, appropriate, and feasible across clinics. Fidelity to the group care model was high. During each session as part of structured observation the research team noted common health issues, the most common one among women was high blood pressure and among infants was flu-like symptoms. The most common services received within the group space was family planning and infant vaccinations. Women reported gaining knowledge from health promotion group discussions and activities. There were some challenges implementing group sessions. Conclusion We found that clinics in Blantyre District, Malawi were able to implement group postpartum and well-child care with fidelity and that it was highly acceptable, appropriate, and feasible to women and health care workers. Due to these promising results, we recommend future research examine the effectiveness of the model on maternal and child health outcomes.

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Multilevel Factors Associated With Participation in Group Well-Child Care

Aloe

Hall

Pérez‐Escamilla

et al. 2023

Academic Pediatrics

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Pediatric Practice Redesign with Group Well Child Care Visits: A Multi-Site Study

Cited by 8 publications

References 22 publications

A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research

A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research

Evaluation of implementation outcomes of an integrated group postpartum and well-child care model at clinics in Malawi

Multilevel Factors Associated With Participation in Group Well-Child Care

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