Caregiver and Clinician Perspectives on Missed Well-Child Visits

Ann Fam Med. 2020 Jan;18(1):30-34. doi: 10.1370/afm.2466.


Purpose: Despite the benefits of well-child care visits, up to one-half of these visits are missed. Little is known about why children miss them, so we undertook a qualitative study to elucidate these factors.

Methods: We interviewed 17 caregivers whose children had missed well-child visits and 6 clinicians, focusing on 3 areas: the value of well-child visits, barriers to attendance, and facilitators of attendance. Transcripts were analyzed with a grounded theory approach and thematic analysis.

Results: Caregivers and clinicians identified similar important aspects of well-child visits: immunizations, detection of disease, and monitoring of growth and development. Both groups identified similar barriers to attendance: transportation, difficulty taking time off from work, child care, and other social stressors.

Conclusions: Further work to explore how addressing social determinants of health might improve attendance of well-child visits is needed.

Keywords: attendance; barriers; children; pediatrics; practice-based research; primary care; social determinants of health; vulnerable populations; well-child visits.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Caregivers / psychology*
  • Child
  • Child Health*
  • Female
  • Humans
  • Male
  • Office Visits*
  • Physical Examination
  • Preventive Health Services
  • Professional-Family Relations
  • Qualitative Research
  • Social Determinants of Health