Child Healthcare at MATER - Pediatric Study

Measured as both utilization and experience of well child care. Utilization will be defined as total number of well child care visits during the child's first 18 months of life. Adequacy of well child care during this time period will be dichotomized as adequate (7 well child care visits) or inadequate (<7 well child care visits). This definition is adapted from the Health Plan Employer Data and Information Set (HEDIS) measure for well child care. The Promoting Healthy Development Survey (PHDS) will be used to evaluate participants' perceptions of their child's well child care, including anticipatory guidance, developmental surveillance, family-centeredness, family risk assessment, and helpfulness of care.

A survey instrument will include investigator-developed questions as well as questions from the Knowledge of Infant Development Inventory (KIDI).

This will be directly assessed using a video recorded mother/child free play at 18 months. Interactions will be coded by using the Keys to Interactive Parenting Scale (KIPS). KIPS is a structured observational measure and assesses 12 domains of parenting. The domains are scored on a 1 to 5-point scale with higher scores indicating higher quality parenting behaviors.

lead screening; up-to-date immunization status based on the CDC immunization schedule; maternal depression screening; PEDS developmental screening; infant Hepatitis C screening among those with perinatal Hepatitis C exposure; number of acute primary care visits (sick visits); emergency department utilization and hospitalization; subspecialist referrals and visits; early intervention referral and enrollment.

self reported using Ages & Stages Questionnaires, 3rd Edition (ASQ-3), a set of 40-item parent-reported age-specific development screening questions assessing communication, gross motor, fine motor, problem solving and personal-social skills. Scores for each of the five domains range from 0-60 with higher scores indicating typical development.

self reported using Ages & Stages Questionnaires, 3rd Edition (ASQ-3), a set of 40-item parent-reported age-specific development screening questions assessing communication, gross motor, fine motor, problem solving and personal-social skills. Scores for each of the five domains range from 0-60 with higher scores indicating typical development.

self reported using Ages & Stages Questionnaires, 3rd Edition (ASQ-3), a set of 40-item parent-reported age-specific development screening questions assessing communication, gross motor, fine motor, problem solving and personal-social skills. Scores for each of the five domains range from 0-60 with higher scores indicating typical development.

self-reported duration of breastfeeding, infant sleep positioning, contraception use , and repeat pregnancy.

depression using the Edinburgh Postnatal Depression Scale

The EPDS is a 10-item self report used to measure postpartum depression. Scores range from 0-30, with a higher score indicating a greater severity of depression.

General stress using the Perceived Stress Scale (PSS; higher scores indicate higher stress)

The Perceived Stress Scale (PSS) is a 10-item scale to measure stress. Scores range from 0-40, with higher scores indicating greater perceived stress.

Parenting stress using the Parenting Stress Index (PSI)

The Parenting Stress Index (PSI) is a 36-item questionnaire assessing parental stress. Total scores range from 36 to 180, with higher scores indicating greater parental stress.

Social support using the Social Provisions Scale (SPS)

The Social Provisions Scale (SPS) is one of the most frequently used scales on social support, and is validated to measure the components of social support that directly impact health outcomes: attachment, social integration, reassurance of worth, reliable alliance, guidance, and opportunity for nurturance.

Any number of positive urine drug screens for illicit substance(s)

Self-reported using the Maternal Responsiveness Questionnaire, which measures the extent to which mothers respond promptly to their infants across different situations. The measure yields 3 subscales: responsiveness, non-responsiveness, and delayed responsiveness. Higher scores indicate higher tendency for responsiveness, non-responsiveness, and delayed responsiveness.

Self-reported using the Coping with Toddlers' Negative Emotions Scale (CTNES) which measures the degree to which mother perceive themselves as reactive to their children's negative affect in distressful situations.

The CTNES consists of scenarios in which youth may experience negative emotion. Parents are asked to identify how they would respond to each scenario. Each scenario has six responses which parents rate on a 7 point Likert-scale regarding their likelihood of responding that way (1 = very unlikely, 7 = very likely). This measure has six subscales which include emotion focused, problem-focused, minimization, punitive, expressive encouragement, and distress responses. Higher scores indicate a higher presence of that parenting response.