Integrating Positive Parenting into Pediatric Primary Care: Evaluation of a Project ECHO Quality Improvement Program

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Publication year

2022

study description

Quality improvement abstract.

core topic(s)

Early Relational Health , Pediatric Primary Care

Population Characteristics

Medical Providers , Medical Trainees

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Community , Disparity/Adversity , Medical Training/Education , Parent Behaviors and Skills , Parent-Child Relationships/Interactions , Positive Parenting , Provider Behaviors and Skills , Provider Knowledge, Attitudes, and Beliefs , Technology and Digital/Screen-Based Media , TeleECHO™

objectives

Quality improvement of a Project ECHO® Maintenance of Certification (MOC) offered to community-based pediatricians and is designed to provide hands-on support to help families to build relationships and skills that can buffer the impacts of adversity. Through monthly TeleECHO™ sessions we hope to demonstrate an increase in providers’ competence in promoting early relational health through positive parenting behaviors.

exposure

TeleECHO™

outcomes evaluated

Provider promotion of ERH parenting behaviors.

setting

Pediatric primary care.

methods

This Project ECHO® Maintenance of Certification (MOC) Part 4 Quality Improvement (QI) program is the first time [The Keystones of Development (KoD) online] curriculum is offered to community-based pediatricians and is designed to provide hands-on support to help families to build relationships and skills that can buffer the impacts of adversity...From May-October 2021, physicians engage in monthly TeleECHO™ sessions guided by a Hub team of experts consisting of two general pediatricians, a child abuse pediatrician, developmental psychologist, licensed clinical social worker, QI coach, and NJAAP Chapter staff. At program start, participant demographics and baseline data on knowledge, attitudes and behaviors were collected. Participants view curriculum modules, discuss implementation practices, and complete a behavioral checklist monthly. Each practice submits one case presentation documenting a particularly challenging or successful patient encounter. Bi-monthly, participants complete chart abstractions to gauge progress towards QI goals. Feedback is collected from participants following each session. Parent surveys will be collected towards the end of the program.

sample size

n=19 (practices); n=20 (physicians)

measures

Measure of Provider Knowledge, Attitudes, and Behaviors: provider surveys collecting demographic data and about ERH promotion, for example:

• • Belief that parenting behaviors can be improved through interactions during well visits?
  • Sufficient time to discuss parenting behaviors?
  • Discussing parenting, modeling parent behaviors, praising caregivers, etc. during visits?

results

Nineteen practices (20 physicians) who have practiced for an average of 24 years are enrolled. Data collection is ongoing. Baseline data shows that the majority (91%) of participants believe that parenting behaviors can be improved through their interactions during well visits, while fewer (41%) feel that they have sufficient time to discuss parenting behaviors. Eighty-two percent of participants felt they had enough knowledge about parenting behaviors to advise parents and caregivers, yet only 53% of knowledge-related pre-test questions were answered correctly. At baseline, participants reported often or always discussing parenting (53%), modeling parenting behaviors (46%), and praising caregivers (76%), and after TeleECHO™ Session 1 these increased to 83%, 90%, and 89% respectively.

conclusions

Baseline data suggests that community pediatricians recognize the importance of their role in promoting positive parenting behaviors in well child care. Although many pediatricians reported already engaging in this behavior, an impressive increase in discussing, modeling and praising positive parenting behaviors occurred after just one TeleECHO™ session. Early data suggests that, like pediatric residents, community pediatricians can benefit from education on promoting positive parenting behaviors via an online curriculum with group discussion. In addition, a digital curriculum offers potential for replication and scale as a MOC opportunity.

limitations

Not discussed.