Pediatric Return Appointment Adherence for Child Welfare-Involved Children in Los Angeles California
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Pediatric Return Appointment Adherence for Child WelfareInvolved Children in Los Angeles California Janet U. Schneiderman1 • Caitlin Smith2 • Janet S. Arnold-Clark3 Jorge Fuentes3 • Andrea K. Kennedy1
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Published online: 31 October 2015 Ó Springer Science+Business Media New York 2015
Abstract Objectives This study of primarily Latino caregivers and Latino child welfare-involved children had the following aims: (1) explore the return appointment adherence patterns at a pediatric medical clinic; and (2) determine the relationship of adherence to return appointments and caregiver, child, and clinic variables. Methods The sample consisted of caregivers of child welfare-involved children who were asked to make a pediatric outpatient clinic return appointment (N = 87). Predictors included caregiver demographics, child medical diagnoses and age, and clinic/convenience factors including distance from the clinic to caregiver’s home, days until the return appointment, reminder telephone call, Latino provider, and additional specialty appointment. Predictors were examined using v2 and t tests of significance. Results Thirty-nine percent of all caregivers were nonadherent in returning for pediatric appointments. When return appointments were scheduled longer after the initial & Janet U. Schneiderman [email protected] Caitlin Smith [email protected] Janet S. Arnold-Clark [email protected] Jorge Fuentes [email protected] Andrea K. Kennedy [email protected] 1
School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA 90089-0411, USA
2
Department of Psychology, University of Southern California, Los Angeles, CA, USA
3
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
appointment, caregivers were less likely to bring children back for medical care. Conclusions The 39 % missed return appointment rate in this study is higher than other similar pediatric populations. Better coordination between pediatricians and caregivers in partnership with child welfare case workers is needed to ensure consistent follow-up regarding health problems, especially when appointments are not scheduled soon after the initial appointment. Keywords Return appointment adherence Latino caregivers Child welfare Foster care
Significance What is already know on this subject? Child welfare-involved children have more health problems than other lowincome children and have barriers to receiving appropriate health care. Child welfare caregivers are the gatekeepers to accessing pediatric health care. What this study adds? In this study, 39 % of child welfare-involved children did not attend their return pediatric outpatient health appointment. Appointment adherence was less when the return appointment was longer in time after the initial appointment. The findings suggest that child welfare and health care systems need to work together to encourage and engage caregivers to assure that pediatric appointments are attended.
Introduction In 2012, child welfare agencies in the U
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