Reducing Socioeconomic Disparities in Health at Pediatric Visits

This project builds upon the PI's prior studies including a recently completed cluster RCT at
community health centers in Boston, which demonstrated a positive impact on provider
referrals, discussion, and family receipt of resources.

This study will specifically test the effectiveness of a further strengthened intervention
"WE CARE 2.0" on provider referrals and family receipt of resources, along with its impact on
child health, health care utilization, and developmental outcomes. Finally, we will gather
information from stakeholders at the health centers in order to learn more about the
facilitators and barriers to implementation of the model.

The study will take place at six community health centers in the Greater Boston area. The
centers will be randomized to either an intervention or control site. Data will be collected
on referrals, receipt of resources, and child outcomes from the child's electronic medical
record (EMR) from birth to age 3. Focus groups will be used to gather implementation data
from intervention health center personnel.

The WE CARE 2.0 intervention consists of: 1) WE CARE surveys which parents complete prior to
their child's well-child visits; 2) information technology (IT) generated provider referrals
which providers use to provide families with resource information sheets; 3) peer patient
navigators who assist families in connecting to available resources and updating providers;
and 4) training sessions for providers and office staff.

Families attending the control health centers will receive standard of care. Of note, since
the health centers share a common EMR and for ethical reasons, control sites will have access
to the IT generated referral mechanism.

Inclusion Criteria:

- Child is on Medicaid insurance

- Is attending routine newborn visit

Exclusion Criteria:

- Premature (less than or equal to 32 weeks GA)

- Has a chronic disease

- Has Neonatal Abstinence Syndrome

- Has a foster parent