"This study comes at a time when our nation is wrestling with the value of healthcare, the importance of high quality care, and the very important role that healthy development in the early years plays in life-long health, education and productivity," said Neal Halfon, MD, MPH, FAAP, professor of pediatrics, public health and public policy at UCLA, director of the UCLA Center for Healthier Children, Families & Communities, and co-author of the overall study. "There is good news in this study, but there are also a number of findings that confirm and corroborate other smaller and more localized studies that suggest the quality of early childhood health care is not what it should be and needs to be."
The survey findings, released by the American Academy of Pediatrics (AAP) in a supplement appearing in the June issue of Pediatrics, were designed to collect reliable information from parents regarding priorities in preventive care for young children. The findings are presented as 10 related research papers authored by the same multidisciplinary and multi-institutional team that collaborated on the design and analysis of the survey. This team consists of researchers from UCLA, the AAP, the Child and Adolescent Health Measurement Initiative (CAHMI), the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration, and the Centers for Disease Control and Prevention (CDC). The survey was carried out by the CDC's National Center for Health Statistics. The research was conducted with support from The Gerber Foundation and the analysis was supported by The Commonwealth Fund.
"Given the importance of preventive care for the health and development of infants and toddlers and the predominant role of pediatricians in their well-child care, we wanted to create a new national data set about the content and quality of the preventive care that children are receiving. Accurate data from parents is key to understanding what families need and the parenting practices that can affect healthy development," remarked Lynn Olson, PhD, co-director of Practice and Research for the AAP. "Pediatricians are interested in providing the best possible care and making sure that they are being responsive to parents' needs and making a difference in children's lives."
The survey reveals important new information about how recent changes in the health care market place may be affecting how health care is practiced. "One of the hallmarks of good quality primary care is a continuous relationship with a provider. This is especially important when the health care provider is tasked with assessing the often subtle changes in a child's development or delving into sensitive issues about how a young family is coping with parenthood," said Moira Inkelas, PhD, assistant professor of health services at UCLA. "What we found was that, while almost all families report a regular place for well-child care, less than half report a regular person providing that care."
"With many states now launching early childhood initiatives like California's First 5 and North Carolina's Smart Start, the data included in this study and provided by the National Survey of Early Childhood Health will be immensely useful for local and state planning and program development efforts," stated Ed Schor, MD, FAAP and assistant vice president of The Commonwealth Fund of New York. "The Commonwealth Fund has made a major commitment to improving the quality and availability of developmental and preventive services for young children, and we hope to see the NSECH survey repeated and expanded so that states can continue to get the information they need to launch local quality and systems improvement efforts."
"This is the first national survey to examine the association between the quality of health and developmental care received and what parents report they are actually doing for their children," stated Michael Kogan, PhD, a co-author of the study. "As the Maternal and Child Health Bureau works with our state MCH colleagues to launch a State Early Childhood Comprehensive Systems Initiative, this survey will provide important information to all state health departments about missed opportunities to receive care, as well as what kind of information and services parents report they need."
The American Academy of Pediatrics partnered with the UCLA Center for Healthier Children, Families & Communities to develop, design and conduct the NSECH. Other collaborators included the Child and Adolescent Health Measurement Initiative (CAHMI) and the Maternal and Child Health Bureau of the Health Resources and Services Administration. The data were collected by the National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), using the State and Local Area Integrated Telephone Survey mechanism. Major funding for the supplement was provided by The Gerber Foundation, with additional support from The Commonwealth Fund; the Health Resources and Services Administration, Maternal and Child Health Bureau; and the American Academy of Pediatrics Friends of Children Fund.
The UCLA Center for Healthier Children, Families and Communities (www.healthychild.ucla.edu) -- supported in part by the Department of Health and Human Services' Health Resources and Services Administration – and directed by Neal Halfon, MD, MPH, FAAP, is a joint program of the UCLA School of Public Health, David Geffen School of Medicine, and UCLA's affiliated medical centers. The Center offers prevention-focused programs to improve individual and community-based health services for children; train health providers to meet today's child and family needs; and improve public policies that affect children and families.
The American Academy of Pediatrics is an organization of 57,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
The National Center for Health Statistics (NCHS) is a component of the Centers for Disease Control and Prevention (CDC). Its mission is to provide statistical information that will guide actions and policies to improve the health of the American people. CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.
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PEDIATRICS