Psychosocial factors associated with preventive pediatric care during the COVID-19 pandemic

BACKGROUND: Identifying the factors that predict non-adherence to recommended preventive pediatric care is necessary for the development of successful interventions to improve compliance. PURPOSE: Given the substantial decline in well-child visits and influenza vaccinations, we sought to examine sociodemographic (i.e., parent age, education, employment status, child age, insurance coverage, household size, race and ethnicity, income, COVID-19 incidence in state) and psychosocial (i.e., child temperament, parent mental health, parent personality traits) factors associated with preventative pediatric care (well-child visits, influenza vaccines) during the COVID-19 pandemic. METHODS: As part of a larger, ongoing study, 1875 parents (96% mothers, 65% age 35 or younger, 58% with a college degree) reported whether they had missed any recommended or scheduled well-child visits since the pandemic and whether they had vaccinated their child against the flu. Using data collected during fall 2020, we examine differences in these health outcomes across social/demographic factors and psychological profiles. In addition, we use lasso logistic regression models to (1) estimate the accuracy with which we can predict adherence from these characteristics and (2) identify factors most strongly, independently associated with adherence. RESULTS: Parent psychological factors were associated with outcomes above and beyond known demographic and social factors. For example, parent industriousness and orderliness were associated with greater likelihoods of attending well-child visits and vaccinating children, while parent conservatism and creativity were associated with lower rates. We also replicate prior work documenting that health insurance, income, and household size are major factors in receiving adequate pediatric care. CONCLUSIONS: Adherence to preventive pediatric care varies as a function of psychological factors, suggesting that the current system of pediatric care favors some psychological profiles over others. However, the specific traits associated with non-adherence point to potentially fruitful interventions, specifically around increasing functional proximity.