Child/Adolescent Health

Parents who explore a preventive health Web site before well-child visits discuss more prevention topics with doctors

Due to time and other constraints, pediatricians spend less than 10 minutes of well-child visits discussing preventive care. However, access to a prevention-focused Web site can prompt parents to bring up prevention topics with their child's provider during well-child visits. It can also increase parental and physician adoption of preventive measures, according to a study supported by the Agency for Healthcare Research and Quality (HS13302). Dimitri A. Christakis, M.D., M.P.H., of the University of Washington, and colleagues randomly assigned 887 children age 11 and younger to 4 groups: usual care, Web content only, Web content and physician notification of topics of interest to the child's parents, and physician notification only.

The Web site, My Healthy Child, provided information to parents about prevention topics based on their child's age and baseline questionnaire data. Physicians could also access the site from their office computers to find out the information of interest to parents. Topics of interest ranged from hot water heater temperature, gun storage, and television viewing to use of bike helmets and car seats. Complete data, including responses to telephone surveys conducted 2 to 4 weeks after the visit, were available for 767 families.

Before their child's checkup, 93 percent of parents visited the Web site; 13 percent did so from the kiosk in the doctor's waiting room. Providers accessed the Web site 160 times. The researchers estimated provider usage at about 46 percent, given the number of patients. Parents in the notification/content and in the notification alone groups reported discussing 9 percent and 8 percent, respectively, more healthy child topics with their provider. Differences between the content-only arm and the usual care arm were not significant.

Also, parents in the content/notification or content alone groups reported implementing 7 percent and 5 percent, respectively, more healthy child topic suggestions at home. Differences between the notification-only arm and the usual care group were not significant.

More details are in "Improving pediatric prevention via the Internet: A randomized, controlled trial," by Dr. Christakis, Frederick J. Zimmerman, Ph.D., Frederick P. Rivara, M.D., M.P.H., and Beth Ebel, M.D., M.P.H., M.Sc., in the September 2006 Pediatrics 118(3), pp. 1157-1166.

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