Uncovering Why Immigrant Children Are Missing Child-Well Visits Compared to Their Natural-Born Peers and How to Mend This Disparity

by David Ngo

Coauthors: Sharief Taraman: Principal Investigator Special thank you to Dustin Johnson for giving me the idea for this research, Dr. Parvin Shahrestani of California State University Fullerton for helping with the publication process, Christy Ocampo, Debra Beauregard, and Dr. Sheila Modir of CHOC for their feedback on the project and book.

Medical Devices & Digital Health

Child Well Visits (CWVs) are essential to a child’s well-being; they screen a child’s development to ensure the child has met developmental milestones and screen for developmental disabilities if the child has not met certain developmental milestones. For this reason, the American Academy of Pediatrics recommends eleven CVWs before a child turns 3 and yearly visits from there on until a child turns 21. However, immigrant children are missing CWVs, even when insured; this trend also exists in Canada, a country with universal healthcare. We suspect this disparity is partially attributed to the lower health literacy of immigrant parents, which is associated with worse health outcomes for their children. When a child is born in a developed country, the hospital pediatrician or social worker educates parents on the importance CWVs; immigrant families with no natural-born child would, therefore, not benefit from this intervention, especially those from developing countries. To assess this hypothesis, we seek to compare the CWV rates of immigrant children with no natural-born siblings, immigrant children with at least one natural-born sibling, and immigrant parents with only natural-born children. In addition to the study, we plan to enhance the health literacy of low-income and immigrant parents through children’s books. The book involves a playful way of instructing where you go when your car is broken (a mechanic), whom you see to learn (a teacher), and where you go when you are sick (a doctor); the book quizzes children on what kind of doctor, specifically internist or a pediatrician to clarify the nuanced differences between the two even though both are primary care physicians. The book will then clarify what CWVs are: they are not for treating a sick child but are annual visits to a pediatrician to screen their child’s development. We have finished a draft of the book and are applying for grants to fund the project. Possible methods of dissemination include social outreach by partnering with those involved in the social sciences of healthcare, such as social workers.