P2.140: Recommended Well-Child Visit Adherence in the HealthySteps 0–3 Cohort in New Jersey

Background: Early childhood is a critical period for child development, making well-child visits (WCV) essential for monitoring growth and promoting health. Many mothers and young children, particularly in underserved communities, face barriers to accessible healthcare. HealthySteps (HS) is a national, evidence-based, interdisciplinary pediatric primary care program designed to support positive parenting and early childhood development, with a focus on culturally diverse, low-income families. We piloted the first HS programs in New Jersey, integrating HS Specialists at three primary care sites to enhance care coordination and improve health outcomes for at-risk families. A key objective of this study is to evaluate adherence to recommended WCV schedules, comparing outcomes across levels of support and to national benchmarks.

Methods: Children ages 0-3 (n=3,367) who received primary care at a HS-affiliated practice were included in the study. WCV frequency and timing were assessed for children who established care before their 2 month visit and remained in the practice beyond 15 months (n=661). Among eligible children, the WCV attendance rate was measured by the proportion of children attending six or more WCV between 2 and 15 months. WCV attendance rates were stratified by tier (service intensity based on family needs) and by insurance status (i.e. Medicaid and private). WCV attendance rates were compared to the 2022 national HEDIS average. Data were collected via electronic records.

Results: The median number of WCVs attended by age 15 months was seven, with 83.8% of children (n=554) attending at least 6 WCV. When stratified by tier, there was no significant difference in the proportion of children attending six or more WCVs: 85.6% (Tier 1-lowest risk), 80.3% (Tier 2), and 84.4% (Tier 3-highest risk). Compared to the 2022 national HEDIS benchmark of 56.8%, the proportion of children attending ≥ 6 WCVs at the HS sites was significantly higher for both those with private insurance (90.9% [85.9%-94.2%] p< 0.001) and Medicaid (82.7% [78.9%-86.0%] p=0.001).

Conclusion: Implementation of the HealthySteps model is associated with significantly higher WCV attendance rates compared to national benchmarks, reinforcing the effectiveness of an integrated pediatric-behavioral health care model to improve preventative care adherence and promote early childhood health and development. The lack of differences across tiers suggest that all families, regardless of risk levels, can benefit from HealthySteps support, emphasizing the broad impact of early intervention programs.

Funded by the Burke Foundation, the Turrell Fund, and Hackensack Meridian Health.