Well-child visits (WCV) are an important tool for delivering preventive care to children less than six years of age. Scheduled at regular intervals, these visits serve as avenues for vaccinations, screenings, and other evaluative practices. Researchers have found, however, that adherence with well-child visit recommendations is significantly lower than desired, especially within the African-American population. Barriers to receipt of WCV have been the focus of many studies seeking to understand why well-child visit recommendations are not being met. Despite the wealth of knowledge examining the causes behind well-child visit adherence, there is a lack of studies examining the perception of barriers and facilitators to care among mothers enrolled in home visitation programs. The purpose of this research study is to understand the perceptions of barriers and facilitators to well-child visits in the at-risk, African-American first-time mother population who are enrolled in a home visitation program.
A qualitative research study was conducted to assess these perceptions of barriers and facilitators. The data for the study were obtained through a series of in-depth, semi-structured interviews with a sample of 10 first-time, at-risk mothers enrolled in the Every Child Succeeds (ECS) home visitation program. All of the participants were African-American, and ranged in age from 18 to 28 years, with an average age of 23 years. The age of babies ranged from 12 to 30 months, with 24 months being the most common age.
The results indicate that mothers enrolled in home visitation programs face some similar barriers as mothers who are not enrolled in these programs. The two most commonly cited barriers were problems with obtaining transportation and balancing work/life obligations. Some less commonly cited barriers were long office waits and overcrowded offices. There were four most commonly cited facilitators: assistance with transportation, personal responsibility, value of the child, and encouragement from the participants' home visitors. Additionally, the participants had a higher rate of WCV attendance than the general African-American population. It is hypothesized that the mothers possessed high levels of intrinsic motivation driven by their maternal obligation and priority placed on their child, which allowed them to overcome many of the traditional barriers (e.g., transportation).
These results are important because they show that while African-American mothers enrolled in home visitation programs share some similar barriers with the broader population, they are affected by unique facilitators not found in previous literature. Further research should examine the roles these facilitators play in overcoming barriers. If maternal obligation and perceived value of the child are found to significantly affect WCV rates, home visitation programs and other similar curricula can be tailored to foster these perceptions.