Association of family-centered care with improved anticipatory guidance delivery and reduced unmet needs in child health care

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19 Scopus citations


Little is known about the association of family-centered care (FCC) with the quality of pediatric primary care. The objectives were to assess (1) associations between family-centered care (FCC), receipt of anticipatory guidance, and unmet need for health care; and (2) whether these associations vary for children with special health care needs (CSHCN). The study, a secondary data analysis of the 2004 Medical Expenditure Panel Survey, used a nationally representative sample of family members of children 0-17 years. We measured receipt of FCC in the last 12 months with a composite score average >3.5 on a 4 point Likert scale from 4 Consumer Assessment of Healthcare Providers and Systems questions. Outcome measures were six anticipatory guidance and six unmet health care service needs items. FCC was reported by 69.6% of family members. One-fifth (22.1%) were CSHCN. Thirty percent of parents reported ≥4 of 6 anticipatory guidance topics discussed and 32.5% reported ≥1 unmet need. FCC was positively associated with anticipatory guidance for all children (OR = 1.45; 95% CI 1.19, 1.76), but no relation was found for CSHCN in stratified analyses (OR = 1.01; 95% CI .75, 1.37). FCC was associated with reduced unmet needs (OR = .38; 95% CI .31, .46), with consistent findings for both non-CSHCN and CSHCN subgroups. Family-centered care is associated with greater receipt of anticipatory guidance and reduced unmet needs. The association between FCC and anticipatory guidance did not persist for CSHCN, suggesting the need for enhanced understanding of appropriate anticipatory guidance for this population.

Original languageEnglish (US)
Pages (from-to)1228-1237
Number of pages10
JournalMaternal and child health journal
Issue number8
StatePublished - Nov 2011


  • Anticipatory guidance
  • Children with special health care needs
  • Family-centered care
  • Physician/patient relationship
  • Primary care

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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