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Pamela C. Hull, PhD1, Robert S. Levine, MD2, Janice S. Emerson, MS3, Baqar A. Husaini, PhD3, Michelle Reece, MS3, and Cynthia Jackson, MS3. (1) Sociology & Center for Health Research, Vanderbilt Univerity & Tennessee State University, 3500 John A. Merritt Boulevard, Box 9580, Nashville, TN 37209, 615-320-3005, pam.hull@vanderbilt.edu, (2) Preventive Medicine, Meharry Medical College, 1005 DB Todd Blvd, Nashville, TN 37208, (3) Center for Health Research, Tennessee State University, Box 9580, 3500 John A. Merritt Boulevard, Nashville, TN 37209
BACKGROUND: Well-child visits are relatively low among low-income and racial/ethnic minority children. Routine pediatric visits represent an opportunity to deliver needed clinical preventive services to children may not otherwise receive well-child care.
PURPOSE: This paper assesses (1) racial/ethnic differences in pediatric preventive service needs, and (2) the impact of a nurse-administered, protocol-driven model for clinical preventive services delivery.
METHODS: The study enrolled 514 new patients in a low-income pediatric clinic, of whom 63% were African American, 17% White, and 20% Hispanic/Other. Using a protocol based on USPSTF recommendations, the nurse assessed the clinical preventive service needs of each patient (screening, immunization, counseling), then documented which services were completed or ordered by the nurse or the physician.
RESULTS: (1) There were no differences in the total number of screening services due, although African American children were most likely (Hispanic/Other children least likely) to need at least one screening service. The number of immunizations due was highest for Hispanic/Other children and lowest for African American children. The number of counseling needs was highest for African American children and lowest for Hispanic/Other children, particularly regarding diet/exercise and dental health. (2) Using the nursing protocol, virtually all of the identified preventive service needs were delivered or initiated (100% of screening services, 99.5% of immunization services, and 100% of counseling services).
CONCLUSIONS: Results highlight significant racial/ethnic differences in needs for specific preventive services, and that this nursing protocol is a feasible model for integrating equitable preventive services into routine pediatric visits.
Learning Objectives:
Keywords: Clinical Prevention Services, Children and Adolescents
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.