Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| 5R01HD088586 | U.S. NIH Grant/Contract | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | NIH |
Not provided
Not provided
Not provided
Not provided
Not provided
Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT) is a team-based approach to care using a health educator ("Parent Coach") to provide the bulk of WCC services, address specific needs faced by families in low-income communities, and decrease reliance on the clinician as the primary provider of WCC services. The Parent Coach provides anticipatory guidance, psychosocial and social needs screening/referral, and developmental and behavioral surveillance, screening, and guidance at each WCC visit, and is supported by parent-focused pre-visit screening and visit prioritization, a brief, problem-focused clinician encounter for a physical exam and any concerns that require a clinician's attention, and an automated text message parent reminder and education service for periodic, age-specific messages to reinforce key health-related information recommended by Bright Futures national guidelines.
The investigators will conduct a cluster RCT of PARENT to determine its effects on quality, utilization, and clinician efficiency, and its cost/cost-offset.
Well-Child Care (WCC) visits for child preventive care during the first three years of life are critical because they may be the only opportunity before a child reaches preschool to identify and address important social, developmental, behavioral, and health issues that could have significant impact and long-lasting effects on children's lives as adults. Despite its potential, multiple studies have demonstrated that pediatric providers fail to provide all recommended preventive and developmental services at these visits and that most parents leave the visit with unaddressed psychosocial, developmental, and behavioral concerns. Further, these missed opportunities are more pronounced for children in low-income families.
A critical problem is that the structure of WCC in the U.S. cannot support the vast array of WCC needs of families. Key structural problems include (a) reliance on clinicians (pediatricians, family physicians, or nurse practitioners) for basic, routine WCC services, (b) limitation to a 15-minute face-to-face clinician-directed WCC visit for the wide array of education and guidance services in WCC, and (c) lack of a systematic, patient-driven method for visit customization to meet families' needs. These structural problems contribute to the wide variations in processes of care and preventive care outcomes, resulting in poorer quality of WCC and perhaps worse health outcomes, particularly for children in low-income communities.
To address the gaps in current WCC this study introduces a new model of care to meet the needs of children in low-income communities: Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT). PARENT is a team-based approach to care using a health educator ("Parent Coach") to provide the bulk of WCC services, address specific needs faced by families in low-income communities, and decrease reliance on the clinician as the primary provider of WCC services. The Parent Coach provides anticipatory guidance, psychosocial screening/referral, and developmental and behavioral surveillance, screening, and guidance at each WCC visit, and is supported by parent-focused pre-visit screening and visit prioritization, a brief, problem-focused clinician encounter for a physical exam and any concerns that require a clinician's attention, and an automated text message parent reminder and education service for periodic, age-specific messages to reinforce key health-related information recommended by Bright Futures national guidelines.
To assess the efficacy of PARENT, the investigators will conduct a cluster randomized controlled trial (RCT). The study will be conducted in partnership with 10 clinics.
In preparation for the trial, investigators will use a Community Engagement & Intervention Implementation process that has been successful in previous studies to guide the intervention adaptation process, Parent Coach training, practice workflow, and intervention implementation in the practices. For the study trial, the investigators will conduct a cluster RCT of PARENT to determine its effects on quality, utilization, and clinician efficiency, and its cost/cost-offset. The project's community partners include two federally-qualified health centers (FQHC). FQHC #1 has 4 clinics participating in the study and FQHC #2 has 6 clinics participating in the study. The total number of clinics participating in the study is 10 clinics randomized at the clinic level to intervention or control condition. The intervention clinics will implement PARENT for all well-visits through age 2 years at their clinical site, and the control clinics will continue usual care (clinician directed well-visit). 1,000 families will be enrolled at infant age ≤12 months and remain in the study for a period of 12 months. Parents will complete a survey at baseline and at 6 and 12-months post enrollment.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | Parents will meet with a Parent Coach during child's routine well visits, and have access to the parent coach between visits for additional follow up and concerns, and have access to a preventive care text messaging services (Healthy Txt). |
|
| Control | No Intervention | usual care well child care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Parent Coach | Other | The Parent Coach intervention uses a health educator who provides anticipatory guidance, psychosocial screening/ referral, and developmental/behavioral surveillance, screening, and guidance at each well-visit. The Parent Coach uses a parent-focused, pre-visit questionnaire to customize the visit to the parents' needs. Every well-visit includes a brief, problem-focused encounter with a clinician for a physical exam and any concerns that require a clinician's attention. Finally, an automated text message service provides for periodic, age-specific messages to reinforce key health messages from Parent Coach-led well-visits. |
| Measure | Description | Time Frame |
|---|---|---|
| Receipt of Preventive Care Services: Anticipatory Guidance Topics Received by Parent Report at Well Visits | Using anticipatory guidance items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents receive the recommended anticipatory guidance topics. scale, 0-100, higher is better | 12 months post enrollment |
| Healthcare Utilization: Emergency Department Utilization | any emergency department care visit for the index child in past 12 months (parent report) | 12 months post enrollment |
| Measure | Description | Time Frame |
|---|---|---|
| Clinician Time With Parent During the Well-Child Care (WCC) Visit, From Observations of Well Child Care Visit | time spent in parent-provider visit during the well child care visit. these data were not collected for trial participants at baseline. At follow-up, we did not collect data due to pandemic restrictions in doing observations. | Data not collected due to COVID Pandemic restrictions on in clinic observations. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Tumaini R Coker, MD/MBA | Seattle Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, Los Angeles | Los Angeles | California | 90095 | United States | ||
| Seattle Children's Research Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28232142 | Background | Mimila NA, Chung PJ, Elliott MN, Bethell CD, Chacon S, Biely C, Contreras S, Chavis T, Bruno Y, Moss T, Coker TR. Well-Child Care Redesign: A Mixed Methods Analysis of Parent Experiences in the PARENT Trial. Acad Pediatr. 2017 Sep-Oct;17(7):747-754. doi: 10.1016/j.acap.2017.02.004. Epub 2017 Feb 14. | |
| 26908675 | Background | Coker TR, Chacon S, Elliott MN, Bruno Y, Chavis T, Biely C, Bethell CD, Contreras S, Mimila NA, Mercado J, Chung PJ. A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial. Pediatrics. 2016 Mar;137(3):e20153013. doi: 10.1542/peds.2015-3013. Epub 2016 Feb 10. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Of 937 enrolled participants, 914 remained enrolled and were eligible to complete 12-month follow-up.
Participants are unique parent/child dyads. The parents were enrolled and each parent had an index child that they provided data on. This was the child for who they were coming to the clinic for a well child visit, and the child had to be 12 months of age or younger.
Participants were recruited from two multi-site federally qualified health centers (FQHCs) in California and Washington State, with 6 and 4 participating practices each. The first participant was enrolled March 5, 2019 and the last participant was enrolled July 1, 2021. **PLEASE NOTE that there were not multiple phases to the trial. this study was a cluster RCT that did not have multiple phases to the trial.
| ID | Title | Description |
|---|---|---|
| FG000 | Intervention | Clinics assigned to the intervention arm will use the Parent Coach model for well child care visits, for children ages 0-2. Parents will meet with a Parent Coach during child's routine well visits, and have access to the parent coach between visits for additional follow up and concerns, and have access to a preventive care text messaging services (Healthy Txt). Parent Coach: The Parent Coach intervention uses a health educator who provides anticipatory guidance, psychosocial screening/ referral, and developmental/behavioral surveillance, screening, and guidance at each well-visit. The Parent Coach uses a parent-focused, pre-visit questionnaire to customize the visit to the parents' needs. Every well-visit includes a brief, problem-focused encounter with a clinician for a physical exam and any concerns that require a clinician's attention. Finally, an automated text message service provides for periodic, age-specific messages to reinforce key health messages from Parent Coach-led well-visits. |
| FG001 | Control | Clinics assigned to control group use usual well child care. They do not have a parent coach as part of the visit. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
participants are parent/child dyads. Each dyad includes 1 parent with 1 child. there is no overlap-- so that the number of parents is equal to the number of children in the study. each parent/child dyad is from a unique family. This is the overall number of participants (914) contributing baseline data. Not all participants answered every baseline question, so the number for each of the baseline measures does not match with the total participating.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Intervention | Parents will meet with a Parent Coach during child's routine well visits, and have access to the parent coach between visits for additional follow up and concerns, and have access to a preventive care text messaging services (Healthy Txt). Parent Coach: The Parent Coach intervention uses a health educator who provides anticipatory guidance, psychosocial screening/ referral, and developmental/behavioral surveillance, screening, and guidance at each well-visit. The Parent Coach uses a parent-focused, pre-visit questionnaire to customize the visit to the parents' needs. Every well-visit includes a brief, problem-focused encounter with a clinician for a physical exam and any concerns that require a clinician's attention. Finally, an automated text message service provides for periodic, age-specific messages to reinforce key health messages from Parent Coach-led well-visits. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Child Age (months). Parents reported on age of child. We did not collect data on parent age |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Receipt of Preventive Care Services: Anticipatory Guidance Topics Received by Parent Report at Well Visits | Using anticipatory guidance items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents receive the recommended anticipatory guidance topics. scale, 0-100, higher is better | Posted | Mean | Standard Deviation | score on a scale | 12 months post enrollment |
|
12 months
As there were no risk of harm to participant dyads, we did not conduct a systematic approach to collecting data on harms. However, if in the course of the 12-month data collection, we gained information on participant harm to either the parent or child of the dyad, we report those as "adverse events". The only such information we received was on one parent of the parent/child dyads enrolled, and this event (parent death) is reported both in the serious adverse event and in all cause mortality.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Intervention | Parents will meet with a Parent Coach during child's routine well visits, and have access to the parent coach between visits for additional follow up and concerns, and have access to a preventive care text messaging services (Healthy Txt). Parent Coach: The Parent Coach intervention uses a health educator who provides anticipatory guidance, psychosocial screening/ referral, and developmental/behavioral surveillance, screening, and guidance at each well-visit. The Parent Coach uses a parent-focused, pre-visit questionnaire to customize the visit to the parents' needs. Every well-visit includes a brief, problem-focused encounter with a clinician for a physical exam and any concerns that require a clinician's attention. Finally, an automated text message service provides for periodic, age-specific messages to reinforce key health messages from Parent Coach-led well-visits. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| death | General disorders | Non-systematic Assessment | the parent enrolled in the study passed away during the study period. |
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tumaini R. Coker, MD, MBA | Seattle Children's | 206-884-0559 | Tumaini.Coker@seattlechildrens.org |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 14, 2021 | Jan 10, 2023 | Prot_SAP_000.pdf |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Receipt of Preventive Care Services: Psychosocial Screening Received by Parent Report at Well Visits | Using items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents received psychosocial assessment on all 7 items | 12 months post enrollment |
| Receipt of Preventive Care Services: Developmental Concerns Addressed and Screening Received by Parent Report at Well Visits. | Using items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents receive the recommended developmental screening and were asked if they had their developmental concerns addressed. | 12 months post enrollment |
| Healthcare Utilization: Hospitalizations | any hospitalizations for index child in past 12 months by parent report | 12 months post enrollment |
| Healthcare Utilization: Well Child Care Visits Up to Date | up to date on well child care by clinic electronic medical record review at 12 months post enrollment | 12 months post enrollment |
| Experiences of Care: Helpfulness of Care Assessment by Parent Report | parent reported helpfulness of care, using items adapted from Promoting Healthy Development Survey scale is 0-100, higher is better | 12 months post enrollment |
| Experiences of Care: Family Centeredness of Care- Whether it Was Received by Parent Report | receipt of family centeredness of care using items adapted from National Survey of Children's Health scale 0-100, higher is better | 12 months post enrollment |
| Seattle |
| Washington |
| 98121 |
| United States |
| 23457149 | Background | Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. Well-child care clinical practice redesign for young children: a systematic review of strategies and tools. Pediatrics. 2013 Mar;131 Suppl 1(Suppl 1):S5-25. doi: 10.1542/peds.2012-1427c. |
| 24936004 | Background | Coker TR, Moreno C, Shekelle PG, Schuster MA, Chung PJ. Well-child care clinical practice redesign for serving low-income children. Pediatrics. 2014 Jul;134(1):e229-39. doi: 10.1542/peds.2013-3775. Epub 2014 Jun 16. |
| 40742591 | Derived | Coker TR, Lowry SJ, Dwibedi E, Salaguinto T, Szilagyi PG, Fiscella K, Rangel SJ, Ortiz J, Weaver MR. Cost Analysis of the PARENT Trial of Community Health Workers in Early Childhood Preventive Care: A Secondary Analysis of a Cluster-Randomized Clinical Trial. JAMA Netw Open. 2025 Jul 1;8(7):e2522732. doi: 10.1001/jamanetworkopen.2025.22732. |
| 37120800 | Derived | Coker TR, Liljenquist K, Lowry SJ, Fiscella K, Weaver MR, Ortiz J, LaFontaine R, Silva J, Salaguinto T, Johnson G, Friesema L, Porras-Javier L, Guerra LJS, Szilagyi PG. Community Health Workers in Early Childhood Well-Child Care for Medicaid-Insured Children: A Randomized Clinical Trial. JAMA. 2023 May 23;329(20):1757-1767. doi: 10.1001/jama.2023.7197. |
| 34842563 | Derived | Hurst R, Liljenquist K, Lowry SJ, Szilagyi PG, Fiscella KA, Weaver MR, Porras-Javier L, Ortiz J, Sotelo Guerra LJ, Coker TR. A Parent Coach-Led Model of Well-Child Care for Young Children in Low-Income Communities: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc. 2021 Nov 25;10(11):e27054. doi: 10.2196/27054. |
| Became ineligible |
|
| BG001 | Control | usual care well child care |
| BG002 | Total | Total of all reporting groups |
911 participants responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question)
| Mean |
| Standard Deviation |
| months |
|
| Sex/Gender, Customized | Participant (parent/caregiver) relationship to child. Child sex/gender was not collected. | 911 respondents responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Parent race/ethnicity (child race/ethnicity not collected) | 911 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Number | participants |
|
| Primary language spoken at home | Parent reported parent primary language spoken at home | 913 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Respondent country of birth | Parent reported parent country of birth | 912 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Respondent marital status | Parent reported parent marital status | 913 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Number of adults in the home | 913 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Number of children that parent has | 913 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Child health insurance | Parent reported insurance type for enrolled child | 912 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Child chronic medical problems | Parent report of enrolled child chronic medical problems | 912 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Trouble paying for any household expenses | Parent report of "some" or "a lot" of trouble paying for any household expenses in the past 12 months | 907 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Highest level of education completed | Parent highest level of education | 912 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Household Annual Income | Parent reported household annual income | 768 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| Child's current overall health | Parent reported child's current overall health | 908 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Count of Participants | Participants |
|
| PROMIS (Patient-Reported Outcomes Measurement Information System) 2-item Global Mental Health | PROMIS measures generate T-scores. T-scores are standard scores with a mean of 50 and standard deviation of 10 in a reference population. PROMIS Mental Health was calculated by summing two 5-point Likert scale questions for a total possible of 2-10 (9 values), then converting those sums to corresponding PROMIS T-scores, for 9 T-score values ranging from 25.8-64.6. Higher scores represent better outcomes. https://staging.healthmeasures.net/images/PROMIS/manuals | 906 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Mean | Standard Deviation | T-Score |
|
| PROMIS (Patient-Reported Outcomes Measurement Information System) 2-item Global Physical Health | PROMIS measures generate T-scores. T-scores are standard scores with a mean of 50 and standard deviation of 10 in a reference population. PROMIS Physical Health was calculated by summing 2 5-point Likert scale questions for a total possible of 2-10 (9 values), then converting those sums to corresponding PROMIS T-scores, for 9 T-score values ranging from 23.4-63.3. Higher scores represent better outcomes. https://staging.healthmeasures.net/images/PROMIS/manuals | 907 respondents of 914 responded to this item.Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Mean | Standard Deviation | T-Score |
|
| PROMIS (Patient-Reported Outcomes Measurement Information System) 4-item Emotional Support Score | PROMIS measures generate T-scores. T-scores are standard scores with a mean of 50 and standard deviation of 10 in a reference population. PROMIS Emotional Support was calculated by summing 4 5-point Likert scale questions for a total possible of 4-20 (17 values), then converting those sums to corresponding PROMIS T-scores, for T-score values ranging from 25.7-62.0. Higher scores represent better outcomes. https://staging.healthmeasures.net/images/PROMIS/manuals | 905 respondents of 914 responded to this item. Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Mean | Standard Deviation | T-Score |
|
| OG001 | Control | usual care well child care |
|
|
| Primary | Healthcare Utilization: Emergency Department Utilization | any emergency department care visit for the index child in past 12 months (parent report) | all participants completing 12 month survey | Posted | Count of Participants | Participants | 12 months post enrollment |
|
|
|
| Secondary | Clinician Time With Parent During the Well-Child Care (WCC) Visit, From Observations of Well Child Care Visit | time spent in parent-provider visit during the well child care visit. these data were not collected for trial participants at baseline. At follow-up, we did not collect data due to pandemic restrictions in doing observations. | Data were not collected due to COVID 19 pandemic restrictions on in clinic observations | Posted | Data not collected due to COVID Pandemic restrictions on in clinic observations. |
|
|
| Secondary | Receipt of Preventive Care Services: Psychosocial Screening Received by Parent Report at Well Visits | Using items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents received psychosocial assessment on all 7 items | all participants completing 12 month survey | Posted | Count of Participants | Participants | 12 months post enrollment |
|
|
|
| Secondary | Receipt of Preventive Care Services: Developmental Concerns Addressed and Screening Received by Parent Report at Well Visits. | Using items adapted from the Promoting Healthy Development Survey, the investigators will assess whether parents receive the recommended developmental screening and were asked if they had their developmental concerns addressed. | Number analyzed differs from overall because of missing data (participant did not respond to item in question) | Posted | Count of Participants | Participants | 12 months post enrollment |
|
|
|
| Secondary | Healthcare Utilization: Hospitalizations | any hospitalizations for index child in past 12 months by parent report | all participants completing 12 month survey | Posted | Count of Participants | Participants | 12 months post enrollment |
|
|
|
| Secondary | Healthcare Utilization: Well Child Care Visits Up to Date | up to date on well child care by clinic electronic medical record review at 12 months post enrollment | all enrolled participants who remained eligible, and consented to chart review by the 12-month post intervention assessment | Posted | Count of Participants | Participants | 12 months post enrollment |
|
|
|
| Secondary | Experiences of Care: Helpfulness of Care Assessment by Parent Report | parent reported helpfulness of care, using items adapted from Promoting Healthy Development Survey scale is 0-100, higher is better | all participants completing 12 month survey | Posted | Mean | Standard Deviation | score on a scale | 12 months post enrollment |
|
|
|
| Secondary | Experiences of Care: Family Centeredness of Care- Whether it Was Received by Parent Report | receipt of family centeredness of care using items adapted from National Survey of Children's Health scale 0-100, higher is better | all participants completing 12 month survey | Posted | Mean | Standard Deviation | score on a scale | 12 months post enrollment |
|
|
|
| 0 |
| 452 |
| 0 |
| 452 |
| 0 |
| 452 |
| EG001 | Control | usual care well child care | 1 | 485 | 1 | 485 | 0 | 485 |
|
Not provided
Not provided
| Other |
|
| Living with a partner |
|
| Separated |
|
| Single (never married & currently not living with a partner) |
|
| 3 adults |
|
| 4 or more adults |
|
| 3 children |
|
| 4 or more children |
|
| Military |
|
| Uninsured |
|
| More than one |
|
| Unknown |
|
| 2-Year college or some college |
|
| 4-Year college degree or greater |
|
| $50,000 to $69,999 per year |
|
| $70,000 or more |
|
| Good |
|
| Fair/poor |
|
| Developmental Screening |
|
|