Development and Implementation of a Culturally Tailored Early Childhood Program in an Integrated Pediatric Primary Care Practice

Objective: Evidence demonstrates the importance of providing anticipatory guidance in interdisciplinary pediatric primary care to promote optimal social–emotional development of young children. However, there is a paucity of research available regarding the development and implementation of such programs within large refugee or immigrant populations. Our goal was to develop a culturally sensitive universal anticipatory guidance program delivered by an integrated behavioral health consultant that would be feasible and acceptable in a busy pediatric primary care clinic (PPCC). Method: Participants were caregivers of children (0 to 36 months), primary care providers, and nursing staff in an urban PPCC. Program development and evaluation followed the Plan-Do-Study-Act quality improvement methodology. A needs assessment was developed and administered to primary care staff and families to identify barriers and value-based program targets to aid in culturally sensitive program development. Feasibility and acceptability were measured by satisfaction surveys. Results: All stakeholders identified the need for this type of programming in the clinic. Space, time, and workflow impact were the most reported perceived barriers. Stakeholders varied in their recommendation of preferred ages for behavioral health consultant (BHC) involvement. Results of the satisfaction surveys revealed that the program was feasible and acceptable. Approximately 20% of patients who presented for the identified well child check visits met with the BHC. Conclusions: Results highlight how stakeholder engagement can be used to support the development and implementation of a culturally sensitive universal early childhood education program in a busy pediatric primary care setting.