Caregiver Concerns About Child Development During the COVID-19 Pandemic Among Those With Missed Appointments: Preliminary Results
Audrey G. Brewer, MD, MPH,
Nina L. Alfieri, MD, MS,
Emily Golbeck, MBA,
Anne Bendelow, MPH,
Michelle L. Macy, MD, MS,
Tracie L. Smith, MPH,
Jenifer Cartland, PhD,
Sarah Babula, MBA,
Matthew M. Davis, MD, MAPP
Affiliations
Audrey G. Brewer, MD, MPH
Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Address correspondence to: Audrey G. Brewer, MD, MPH, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 162, Chicago IL 60611.
Nina L. Alfieri, MD, MS
Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Emily Golbeck, MBA
Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Anne Bendelow, MPH
Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Michelle L. Macy, MD, MS
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Tracie L. Smith, MPH
Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Jenifer Cartland, PhD
Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
Sarah Babula, MBA
Pathways.org, Chicago, Illinois
Matthew M. Davis, MD, MAPP
Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Introduction: The aim of this study is to examine caregivers’ perception of their child falling behind on developmental milestones after canceled or delayed appointments in metropolitan Chicago during stay-at-home orders, from March 21 to May 7, 2020. Methods: We fielded a web-based caregiver survey to understand the impact of the early weeks of the COVID-19 pandemic on children's healthcare experiences, characterizing the proportions of caregiver perceptions of children falling behind in developmental milestones by canceled or delayed appointment types. Multivariable logistic regression was used to estimate the likelihood of falling behind in milestones. Results: Overall, 229 (7.5%) caregivers reported children with canceled or delayed appointments falling behind in developmental milestones. Approximately 25.4% of caregivers reported children falling behind on milestones in the missed therapeutic group, compared with that in the other missed group (2.9%) (p<0.001). Children in the missed therapeutic group (AOR=10.3, 95% CI=7.60, 14.0) and caregivers who experienced job loss (AOR=1.59, 95% CI=1.11, 2.28) or reduced hours or pay (AOR=1.90, 95% CI=1.28, 2.82) had higher odds of falling behind on developmental milestones. Conclusions: Implementation of new strategies to address the social needs of families should be developed when disruptions in developmental or therapeutic services among children occur, particularly among children living in households with job insecurity.