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Comparing Technological and Relational Approaches to Support Families After a Missed Well Child Visit

Not Applicable
Conditions
Well-child Care Visits
Registration Number
NCT06686849
Lead Sponsor
Wake Forest University Health Sciences
Brief Summary

The overall goal of this study is to compare the effectiveness of different follow up protocols for scheduled but not attended ("no-show") Well-Child Visits, relative to care-as-usual (no standardized or typical follow up procedure). The main goals are to:

* Demonstrate feasibility of merging a new referral protocol following Well-Child visit no-show into existing health system Community Health Worker resources.

* Compare Well-Child Visit attendance following no-show between patients randomized to care-as-usual (comparison), text message only (low-touch intervention), and community health worker outreach (high-touch intervention) groups.

* Define the costs and cost-effectiveness of different follow-up protocols.

Detailed Description

Well-Child visits (WCV) are at the core of preventive care in pediatrics. These Visits are an important opportunity for patients to be engaged with the healthcare system, for assessing child health and development, and for screening and counseling for prevention. Missed WCVs have been associated with negative health outcomes as well as avoidable healthcare costs and may occur for a variety of different reasons. There is room for improving follow-up with families to re-engage patients after not attending a scheduled WCV ("no-show"). This study will test and compare a text messaging intervention and community health worker outreach intervention to care-as-usual (no standard follow-up) as strategies for proactively engaging families in care after no-show to promote rescheduling and visit attendance. Evaluating effectiveness and cost-effectiveness of both interventions will inform clinical practice and decision-making in healthcare to help ultimately improve pediatric preventive care.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
5885
Inclusion Criteria
  • Are 0-17 years
  • No-showed for a well-child visit scheduled at a family medicine or general pediatrics practice in Forsyth County, North Carolina
  • Have a phone number on record for a primary caregiver
  • With primary language for contact that is English or Spanish
Exclusion Criteria
  • Already rescheduled their appointment by the time the sample list was generated
  • Caregiver is not 18 years or older

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Proportion of Patients of All Ages with any Completed Well-Child VisitsWeek 6 post missed well-child visit

Whether any Well-Child visit was completed by each patient (yes/no) following usual care, text intervention or community health worker intervention

Proportion of Patients Under 3 Years Old with any Completed Well-Child VisitsWeek 6 post missed well-child visit

Whether any Well-Child visit was completed by each patient (yes/no) following usual care, text intervention or community health worker intervention

Proportion of Patients 3 Years and Older with any Completed Well-Child VisitsMonth 3 post missed well-child visit

Whether any Well-Child visit was completed by each patient (yes/no) following usual care, text intervention or community health worker intervention

Secondary Outcome Measures
NameTimeMethod
Proportion of Patients of All Ages with Any Rescheduled Well-Child VisitWeek 6 post missed well-child visit

Whether any Well-Child visit was rescheduled by each patient (yes/no) following usual care, text intervention or community health worker intervention

Proportion of Patients 3 Years and Older with Any Rescheduled Well-Child VisitMonth 3 post missed well-child visit

Whether any Well-Child visit was rescheduled by each patient (yes/no) following usual care, text intervention or community health worker intervention

Proportion of Patients of All Ages with Vaccination status up-to-date6 weeks post missed well-child visit

Whether each patient is up-to-date on all age-appropriate vaccinations (yes/no)

Proportion of Patients 3 Years and Older with Vaccination status up-to-dateMonth 3 post missed well-child visit

Whether each patient is up-to-date on all age-appropriate vaccinations (yes/no)

Proportion of Patients of All Ages with Any Completed Encounter6 weeks post missed well-child visit

Whether each patient had any completed healthcare encounter within the same health system (yes/no)

Proportion of Patients 3 Years and Older with Any Completed EncounterMonth 3 post missed well-child visit

Whether each patient had any completed healthcare encounter within the same health system (yes/no)

Proportion of Patients of All Ages with Any Non-Well-Child Primary Care Visit6 weeks post missed well-child visit

Whether each patient had any completed non-Well-Child primary healthcare visit within the same health system (yes/no)

Proportion of Patients 3 Years and Older with Any Non-Well-Child Visit Primary Care VisitMonth 3 post missed well-child visit

Whether each patient had any completed non-Well-Child primary healthcare visit within the same health system (yes/no)

Proportion of Patients of All Ages with Any Specialist Visit6 weeks post missed well-child visit

Whether each patient had any completed non-Well-Child specialist visit within the same health system (yes/no)

Proportion of Patients 3 Years and Older with Any Specialist VisitMonth 3 post missed well-child visit

Whether each patient had any completed non-Well-Child specialist visit within the same health system (yes/no)

Proportion of Patients of All Ages with Any Emergency Department Visit6 weeks post missed well-child visit

Whether each patient had any Emergency Department visit within the same health system (yes/no)

Proportion of Patients 3 Years and Older with Any Emergency Department VisitMonth 3 post missed well-child visit

Whether each patient had any Emergency Department within the same health system (yes/no)

Proportion of Patients of All Ages with Any Hospitalization6 weeks post missed well-child visit

Whether each patient had any hospitalization within the same health system (yes/no)

Proportion of Patients 3 Years and Older with Any HospitalizationMonth 3 post missed well-child visit

Whether each patient had any hospitalization within the same health system (yes/no)

Trial Locations

Locations (1)

Department of Family and Community Medicine, Wake Forest University School of Medicine

🇺🇸

Winston-Salem, North Carolina, United States

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