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

Background: The purpose of this study was to investigate factors related to well-child visit noncompli-ance in an ethnically diverse family practice clinic population. Methods: Participants included 146 parents (131 mothers and 15 fathers) of children aged 0 to 24 months who received care at a St. Paul residency clinic. Participants completed telephone surveys that asked about their demographic characteristics, attitudes toward well-child visits, whether the most re-cent planned well-child visit had been kept, and their own and their child’s health characteristics. Results: All participants thought that well-child visits were important, with immunizations being the highest rated reason for importance. Fourteen percent of parents said they had missed a recent well-child visit, mostly because they forgot. More than three fourths of parents believed visit reminders were helpful, and the preferred type of reminder was a telephone call. Noncompliance with well-child visits was associated with the parent’s depressive symptoms, transportation difficulties, working at a job, hav-ing private (vs public) health insurance, and being older (vs younger). Conclusions: These results suggest that well-child visit compliance might be enhanced by visit re-minders and improved access to transportation. The relationship of well-child visit noncompliance to parental depressive symptoms, if verified in other populations, points to a need for greater surveillance of children/families who do not schedule or keep well-child visits. (J Am Board Fam Pract 2004;17: 324–31.) Children under the age of 18 make up nearly one fifth of all visits to primary care providers.1 Of these visits, well-child visits are the most common and are in fact the leading diagnosis among pediatri-cians and the sixth leading diagnosis for family physicians.1 Well-child visits are important to the health of children, as they are the means whereby children’s growth is monitored, diseases are diag-nosed, vaccines are administered, and education about nutrition, safety, and other important issues is provided. However, appointments for well-child visits are often not made or kept. For example, a recent historic cohort study of over 300,000 chil