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Performance of the Person Centered Primary Care Measure in Pediatric Continuity Clinic
Affiliation:1. Department of Pediatrics (SD Ronis), Case Western Reserve University School of Medicine, Cleveland, Ohio;2. University Hospitals Rainbow Babies and Children''s Hospital (SD Ronis and KK Westphaln), Cleveland, Ohio;3. UH Rainbow Center for Child Health and Policy (SD Ronis), Cleveland, Ohio;4. Department of Bioethics (KK Westphaln), Case Western Reserve University School of Medicine, Cleveland, Ohio;5. Department of Pediatrics (LC Kleinman), Rutgers University Robert Wood Johnson School of Medicine, New Brunswick, NJ;6. Center for Community Health Integration, Departments of Family Medicine & Community Health, Population and Quantitative Health Sciences, Sociology, Case Comprehensive Cancer Center (SJ Zyzanski and KC Stange), Case Western Reserve University, Cleveland, Ohio;7. Larry A. Green, MD Center for the Advancement of Primary Health Care for the Public Good (KC Stange), Richmond, Va;1. Department of Pediatrics, University of Minnesota School of Medicine & Masonic Children''s Hospital (MB Pitt), Minneapolis, Minn;2. Division of General and Community Pediatrics, Cincinnati Children''s Hospital Medical Center, University of Cincinnati College of Medicine (MD Klein), Cincinnati, Ohio;1. Pediatric Residency Training Program, Cincinnati Children''s Hospital Medical Center (JJ Petosa), Cincinnati, Ohio;2. Division of General Pediatrics and Community Pediatrics, Cincinnati Children''s Hospital Medical Center (M Klein), Cincinnati, Ohio;3. Division of Pediatric Emergency Medicine, Cincinnati Children''s Hospital Medical Center (A Martini and D Schumacher), Cincinnati, Ohio;4. University of Cincinnati College of Medicine (M Klein and D Schumacher), Cincinnati, Ohio;1. Duke University School of Medicine (AJ Hish), Durham, NC;2. Department of Pediatrics, Duke University (CT Wood, JB Howard, and EM Perrin), Vienna, Austria;3. Duke Center for Childhood Obesity Research, Duke University School of Medicine (CT Wood, JB Howard, and EM Perrin), Durham, NC;4. Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine (KB Flower);5. Department of Pediatrics, School of Medicine/Bellevue Hospital Center, New York University (HS Yin), New York, NY;6. Center for Health Services Research, Vanderbilt University Medical Center (RL Rothman), Nashville, Tenn;7. University of Miami School of Medicine (AM Delamater), Miami, Fla;8. Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University (LM Sanders), Stanford, Calif;9. Department of Biostatistics, Vanderbilt University School of Medicine (A Bian and JS Schildcrout), Nashville, Tenn;1. Division of General Pediatrics, Department of Pediatrics, Boston Children''s Hospital (JL Wilder, EW Pingree, CM Hark, CH Marcus, and AS Winn), Boston, Mass;2. Harvard Medical School (JL Wilder, EW Pingree, CM Hark, CH Marcus, EC Rabinowitz, and AS Winn), Boston, Mass;3. Division of Pulmonary Medicine, Department of Pediatrics, Boston Children''s Hospital (EC Rabinowitz), Boston, Mass;4. Department of Pediatrics, Boston Medical Center (CD Michelson), Boston, Mass;5. Boston University School of Medicine (CD Michelson), Boston, Mass
Abstract:ObjectiveImprovement efforts in pediatric primary care would benefit from measures that capture families’ holistic experience of the practice. We sought to assess the reliability and validity of the new Person-Centered Primary Care Measure (PCPCM) in a pediatric resident continuity clinic serving low-income families.MethodsWe incorporated the 11-item PCPCM, stems adapted to reflect a parent responding about their child's visit, into a telephone survey of 194 parents presenting for care in October 2019 at a pediatric resident continuity clinic in Cleveland Ohio (64% response rate). We evaluated PCPCM items using factor analysis and Rasch modeling, and assessed associations of the PCPCM with parents’ demographics and perceptions of specific elements of their child's care.ResultsIn this sample of low-income families, the PCPCM had good reliability (Cronbach's alpha 0.85). All items loaded onto a single factor in principal axes factor analysis. Of the 11 aspects of primary care represented in the scale, “shared experience” was most difficult for parents to endorse in Rasch modeling. All 11 items contributed significantly to the total scale score with corrected item-total correlations >0.4. The PCPCM score was independent of socio demographics and was associated with parent's report that their child's clinician spends enough time with them.ConclusionsThe PCPCM performs well in a pediatric continuity clinic setting, warranting consideration for its use as a parsimonious parent-reported measure of what patients and clinicians say matters most in pediatric primary care.
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