Pediatricians Don't Have Time to Address Parental Health

Debra Shute, November 13, 2017

While most physicians believe that parents' challenges with intimate partner violence, family planning, and health insurance affect children's health, far fewer address such issues in practice.

Although most pediatricians and family doctors agree that parental health issues have an important impact on children's health, there is considerably less agreement that it's pediatric physicians' responsibility to address them, according to a study published in Clinical Pediatrics and the Journal of Pediatrics.

The survey focused on practices and attitudes toward six parental health issues recommended for screening by current professional pediatric organizations’ preventive care guidelines:

  • maternal depression
  • tobacco use
  • intimate partner violence (IPV)
  • Tdap (tetanus, diphtheria and acellular pertussis) immunization status
  • health insurance status
  • family planning

Nearly 80% of 239 respondents addressed at least one of the parental health issues at 25% or more of well-child visits. Most frequently, they addressed maternal depression (82.8%) and tobacco use (92.4%) through screening and counseling parents.

Less than half, however, addressed IPV (44.4%), family planning (33.8%), and health insurance status (45.9%).

The top barrier cited by physicians was lack of time (85%), while more than half indicated that referral-related issues were barriers to addressing parental health.

Physicians were also asked to indicate on a five-point scale how strongly they agreed or disagreed with the statements, “I believe the issue is important to child health,” and “I believe it is my responsibility to address this issue.”

A majority agreed that it was their responsibility to address maternal depression (85.7%), tobacco use (93.3%), Tdap immunization status (81.8%), and IPV (62.8 percent). However, less than a third (31.9% and 22.6%, respectively) agreed they were responsible for addressing family planning and health insurance issues.

"Surveys such as ours not only highlight the scope of parental health promotion already occurring in pediatric primary care settings, but also reinforce the need to better understand how health systems can support current practices and what factors influence pediatricians’ attitudes toward engaging in these activities," said Tina Cheng, MD, MPH, pediatrician-in-chief of Johns Hopkins Children’s Center and an author on the paper.

Debra Shute

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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