Parents’ Health and Demographic Characteristics Predict Noncompliance with Well-Child Visits

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Figure 1.
Sample of participants and nonparticipants.

Table 1.

Characteristics of Participants (n = 146)

	N	%	Mean	S.D.
Gender
Female	131	89.7
Male	15	10.3
Ethnicity
Southeast Asian	94	64.8
African American	21	14.5
White	20	13.8
Latin American	4	2.8
Native American	4	2.8
Other	3	2.1
Marital Status
Married	90	61.2
Single, not living with partner	32	21.8
Single, living with partner	24	16.3
Separated	1	0.7
Education
<12th grade	70	48.3
High School diploma	40	27.6
Post-high school	35	24.1
Employed	73	50.3
Age in years			25.9	7.2
Child’s age in months			8.9	5.4
Number of children			3.0	2.2
Number of children <5 years			1.7	0.8
Medical Insurance
Public Assistance	99^*	67.3
Private or other	45	30.6
None	3	2.0

Table 2.

Well-Child Visits (n = 146)

	N	%	Mean	S.D.
Visit Compliance and Related Factors
Visit compliance
Well-child visit made	126	86.3
Appointment not scheduled	14	9.6
Appointment scheduled, but not kept	6	4.1
Reasons for missing visit
Forgot	18	90.0^*
Too busy	7	35.0^*
Transportation problems	5	25.0^*
No care for other children	3	15.0^*
Child ill	2	10.0^*
Transportation difficulty			4.3^†	1.2
Record appointments on calendar	110	82.1			Ride provided for visit by UCare insurance	30	24.0
Parents’ Attitudes toward Well-Child Visits and Visit Reminders
Parent thought well-child visit was important	146	100.0
Why well-child visit is important
Immunizations	102	69.4
Child development	81	55.1
Growth measurements	47	32.0
Full exam	42	28.6
Counseling on parenting, safety	20	13.6
Parents thought appointment reminder was helpful	103	77.4
Type of appointment reminder preferred
Phone call	71	68.3
Letter	24	23.1
Either	9	8.7

* Percentage given as proportion of missed visits (n = 20).
† Responses given on 1 to 5 scale, where 1 = very difficult, 3 = somewhat difficult, and 5 = not at all difficult.

Table 3.

Parents’ Mental Health (n = 146)

Parent	N	%	Mean	S.D.
Bothered by feeling down, depressed, or hopeless over past month	27	18.4
Bothered by having little interest or pleasure in doing things	17	11.6
Positive depression screen (′yes′ to either of above 2 items)	29	19.7
Cries often for known or unknown reasons	18	12.2
Stress level over past month			1.9^*	0.9
Often stressed to always stressed	29	19.9
Causes of stress
Too much to do	24	82.8^†
Financial concerns	14	48.3^†
Employment	6	20.7^†
Illness	3	10.3^†
Lack of help from spouse/partner	2	6.9^†
Conflict with partner	1	3.4^†
Conflict with extended family	1	3.4^†

* Responses given on a 1 to 5 scale, where 1 = not at all stressed, 3 = often stressed, and 5 = always stressed.
† Percentage given as proportion of people who were often to always stressed (n = 29).

Table 4.

Predictors of Well-Child Visit Noncompliance

Independent Variable	Standardized β	P Value	Odds Ratio (C.I.)
Working at a job	2.33	.002	10.0(2.23,47.47)
Insurance: private vs. public	1.84	.022	6.25(1.26,31.50)
Depressive symptoms	1.50	.039	4.55(1.05,19.11)
Transportation availability	−0.69	.005	0.50(1.22,3.25)
Age	0.12	.006	1.12(1.03,1.23)
Nagelkerke’s Pseudo R square = 0.42