Parent, Caregiver Engagement Low During Pediatric Well-Child Visits

Parent and caregiver engagement is missing from many pediatric well-child visits, with new survey data from the University of Michigan showing that parents and guardians come unprepared for those visits.

Healthcare providers can practice stronger patient engagement, including initiating appointment agenda-setting, before well-child visits.

Annual pediatric well-child visits are important for ensuring kids are healthy, developing properly, receiving any applicable early intervention, and staying on track with their childhood vaccine schedules.

“Regular well visits mean guaranteed face time with your child’s doctor and an opportunity to not only discuss specific concerns and questions about your child’s health but get their advice on general health topics like nutrition, sleep and behavior,” Sarah Clark, MPH, the Mott Poll co-director, said in a public statement.

Parents know this and are staying on top of these well-child visits, according to the C.S. Mott Children’s Hospital National Poll on Children’s Health and the University of Michigan Health. Most parents said their child had a well-child visit in the past two years and two-thirds said the visit was with their child’s usual source of care.

“We were pleased to see that the majority of parents regularly make these appointments and maintain relationships with a trusted provider,” said Clark. “But they may not always be taking a proactive approach to ensuring they address all relevant health concerns impacting their child’s physical, emotional and behavioral health at every visit.”

The poll of over 1,300 parents of kids ages 1 to 12 showed that parents are mostly going into pediatric well-child visits blind. Only a quarter said they plan a list of questions ahead of an appointment; one-fifth of parents said they never do this.

One in five parents said they often write down information about their child’s health changes, but three in 10 don’t do this at all.

Coming prepared to a doctor’s appointment is always important, regardless of patient age. For pediatric visits, the responsibility often falls on the parent or guardian. According to Clark, listing questions or making notes about health changes can help the parent caregiver and the provider determine the course of the appointment.

“Well visits are busy, and in the moment, it’s easy for parents to forget to bring up questions or concerns with a doctor,” Clark said. “Writing them down ahead of time will help prioritize topics and help you get the most out of the appointment.”

For example, parents might do a little bit of research about their child’s healthcare needs or changes before an appointment. This can help guide the conversation, Clark said, but only 15 percent of respondents said they do this.

“We are constantly learning new information that may impact children’s health and some recommendations may evolve or be updated,” Clark explained. “Many pediatricians and care providers will bring these topics up themselves but not always. It’s always helpful for parents to do some homework ahead of time to make sure they’re aware of any timely topics affecting their child’s age group.” 

There is something to be said of a pediatric clinician’s responsibility for patient engagement and appointment agenda-setting. Healthcare providers can discuss with parents the importance of bringing specific questions or topics to the next well-child visit or send patient portal messages as part of patient pre-registration to remind parents about agenda-setting.

Providers may also encourage parents or guardians to engage their own children in care. This is particularly important for kids approaching age 12 who are building personal and bodily autonomy.

“As kids approach puberty, their bodies begin changing. A well visit is a great opportunity to have the provider explain why these changes happen,” Clark said. “Having kids think about health topics themselves is also good practice for when they get older and parents become less involved with health visits. Preparing for this transition early will benefit them when they need to take more ownership of their health.”

A little more than a fifth (22 percent) of parents said they encourage their pre-teens to plan questions for their pediatrician, the poll showed.

Although the poll indicated that providers and parents need stronger engagement in appointment agenda-setting and preparation, it also showed that parents are ensuring continuity of care for their kids. Around half of respondents said they schedule well-child visits with their child’s usual pediatrician, even if there will be a long appointment wait time.

Another third of parents agreed that children will be more engaged in their own care if they meet with a provider they already know.

“Nurturing a relationship with a primary care provider means that the health professional who knows your child best is the one providing individualized care and helping your family navigate important decisions impacting their health,” Clark said.

However, given provider shortages and long appointment wait times, the researchers noted that it’s not the end of the world if a child sees a different provider. Clark mentioned that “parents may benefit from different explanations or perspectives on their child’s health.”