This Healthy Tomorrows Partnership for Children Program implemented group well child visits for Asian American immigrant and refugee families and children 0 - 2 years of age. The group visits allowed for caregiver education and support in a culturally competent and financially self-sustainable manner in the context of pediatric medical home.

Implementation Insights:

  • Leverage existing opportunities and infrastructure rather than creating completely new initiatives.
  • Engage diverse families through cultural brokers who represent culturally and linguistically diverse community members.
  • Involve key leaders and stakeholders early to enhance sustainability. 


    Updated: November 2015

 Background Information

  • Type of Practice: Federally Qualified Health Center
  • Location: Oakland, California
  • Population Served: Low-income Asian American immigrant and refugee communities, specifically pregnant women as well as caregivers and children 0-2 years of age. Approximately 120 infants and their caregivers (mostly mothers) have been served by this program since its inception in March 2011.

 Pediatric Medical Home Implementation Strategies

  • Group 8-10 infants of similar age, culture, and language backgrounds together for a group well child visit, allowing a pediatric clinician to spend up to two hours with a group of families.
  • Schedule and implement a series of eight group well child visits over 18 months, based on Bright Futures guidelines.
  • Utilize group visits to implement an interactive child development curriculum which educates caregivers on the following issues:
      • Child development
      • Nurturing and attachment
      • Discipline
      • Stress management
      • Nutrition
      • Safety
  • Invite culturally and linguistically diverse community health workers from target communities to attend and co-facilitate group well child visits. These individuals can foster a culturally competent environment that enhances collaborative learning, care coordination, and caregiver support.
  • Implement team-based, integrated care by supporting on-site case managers and licensed clinical social workers who screen for mental health, toxic stress, and domestic violence among participating families.
  • Convene a project advisory board consisting of community and family members; host meetings 2-3 times per year.
  • Seek feedback from family and community members by hosting focus groups that are facilitated by community leaders rather than project staff.
  • Integrate evaluation components throughout the project to demonstrate project impact and secure funding and support for future endeavors.
  • Explore multiple funding sources including the following:
      • Healthy Tomorrows Partnership for Children Program
      • Every Child Counts
      • Universities
      • Cultural advocacy organizations
      • Title V funded programs

 Challenges

  • Expanding the project beyond a demonstration to a widely adopted part of regular clinic operations was a challenge. The project utilized evaluation results to demonstrate its impact and enhance leadership buy-in for sustainability. Evaluation results included the following:
      • Pre and post surveys were distributed to participating families. Results from the surveys demonstrated increased self-reported social support measures among families; increased utilization of positive discipline approaches; and increased nutritient intake among families and infants.
      • Additional evaluation data indicate that 100% of participating families and children had up-to-date immunizations, 100% of mothers were screened for post-partum depression, and 100% of participating infants underwent structured developmental screening and were referred appropriately. 

 More Information

  • For more information, contact Joan Jeung, MD, MS, FAAP, Director, Empowering Mothers Initiative: joanjeung@gmail.com.
  • For more information about the Healthy Tomorrows Partnership for Children Program (HTPCP), visit the HTPCP Web site.