Date of Award

Spring 5-10-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Shanta Dube

Second Advisor

Dr. Jennifer Zubler

Abstract

Background: Well child care visits (WCC) are critical preventive care visits that start at infancy. Currently, little is known about the association between WCC and parent report of developmental and behavioral health conditions in children. The purpose of this research was to examine if WCC contributes to developmental/behavioral health conditions reported by parents.

Methods: The 2016 National Health Interview Survey data were used for this research. Weighted estimates were calculated to assess the relationship between the receipt of WCC (yes or no response to receiving WCC in past 12 months) and presence of developmental/behavioral conditions; a Pearson’s chi square was used to determine bivariate associations between characteristics and WCC, followed by multivariable logistic regression to adjust for child sex, child age, healthcare access of parents, parent education level and parent income level.

Results: Among 2,453 children 3 years and younger 91.04% of these children had received WCC in the past 12 months. The weighted percent of children with any developmental/behavioral conditions was 7.78% in those receiving WCC and 4.62% in children not receiving WCC. Bivariate associations determined that the statistically significant characteristics for determining whether a child receives WCC are: the child’s race/ethnicity, the number of office visits to their primary care (which are a combination of WCC and sick child visits), parent education level, and combined family income level. The logistic regression model evaluating developmental and behavioral conditions adjusted for these variables that were statistically significant. In the adjusted model it was found that the number of office visits and parent education level were statistically significant in the detection of developmental and behavioral health conditions.

Conclusion: The number of office visits (which include WCC) are important preventive clinical services for identifying developmental/behavioral conditions in young children. Parent education level is another significant factor that determines receipt of WCC and detection of developmental/behavioral conditions. By understanding the factors associated with WCC, targeted interventions can be developed to increase identification of developmental/behavioral conditions.

Available for download on Tuesday, April 30, 2019

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