What are the positive factors that are contributing to you reaching your desired result?

• Varied providers: We have family practice doctors, pediatricians, nurse practitioners, etc. to be able to support families. Located in a variety of areas not just in Corsicana.
• New/expanded hours: Navarro Pediatrics has just added a Saturday clinic and they are also doing a drive-by immunization clinic. 
• Hope Clinic/Waxahachie/DFW/Waco: There are providers in nearby communities that are accessible to some families.
• PEDIA Clinic: Available to low-income families.

What are the negative factors that are restricting you from reaching your desired result?

• COVID: Driving families away from going to the doctor for normal well visits and check-ups.
• Lack of transportation
• Lack of insurance or being underinsured
• Availability: working families need more after hours and weekend options
• Drop off: Families do a good job from birth to 18 months. After that there's a drop-off of kids going yearly
• Doctors often leave the area: hard for families to build rapport and find a consistent doctor in the county. 
• Lack of education/understanding: Parents don't understand why these visits are important, and doctors don't explain the importance well enough. 
• Insurance benefits: many families don't realize that well visits are normally covered by benefits because they are preventative
• Immunizations: some parents are against vaccinations--those are a part of your well checks

What populations are the most disadvantaged and what causes these disparities?

• Families who are undocumented
• Rural families: because of transportation
• Those who lack transportation
• Uninsured and underinsured families
• Unemployed/Underemployed families
• Spanish-speaking families

Are there foreseeable factors that will affect your work over the next few months to a year?

• COVID: Virus is getting worse, more families staying home and away from public
• COVID: Restricting number of visitors can come into appointments with patient. Some parents don't have childcare for other children to go to a visit. 
• COVID Vaccine: will families feel comfortable taking children to be vaccinated?
• New federal administration: may see changes with health insurance system
• School reopening/reclosing: school nurses and teachers will be able to or be restricted from seeing children and encouraging parents to take kids to well visits

What additional research is needed to better understand the factors that influence the slope of the curve and related disparities? 

• PEDIA Clinc: What specific services do they provide and who is eligible?
• Schedule of well visits: how many appointments should a child attend from 0 to 18?
• What clinics in the area have translators or bilingual staff available?
• What are well checks checking for? What types of problems/issues do they prevent? 
• What percent of issues are caught early by a well check?
• What types of legislative actions are in the works for healthcare on state and federal levels?

Who are the partners that can help you reach your desired outcome? List partners and their roles.

• Parents: understanding the benefits of doing well visits
• Clinics, physicians, local hospital. 
• School nurses and teachers
• Counselors in school and in community
• Health Department: PEDIA, WIC
• Daycare directors
• Faith leaders
• Media outlets: to spread the PSA
• School districts

Research/Evidence-Based Practices:

• Health Fair: Where families can search for providers, can do part of a well visit.
• Incentivizing preventative care: Gift cards for doing a well check, giving a book for each kids that comes
• Public Health Campaign: Advertising and doing PSAs about importance of a well check
• Transportation: free transportation to doctors for preventative care

Low Cost/No Cost Solutions:

• Reminders: creative ways of reminding parents when they need to go and how to schedule appointments
• Carpool: for after COVID
• Doctors/Nurses: Have doctors/nurses do meet and greet with physicans and have them come talk to parents about importance of preventative care (could benefit the doctors here to have more families be seen in the county)

Innovative/Out-the-Box Solutions: 

• Childcare: providing childcare during appointments so parent can focus on primary child
• Use the schools to compel families to do the well visits (Ex. athletes).  
• Use technology (Bright by text, Class Dojo, Remind) to connect with families and inform
• County-wide clinic for uninsured and underinsured (FQHC)
• Foundations incentivize preventative care (in gifts or in transportation)

Additional Research:

• Why do many doctors leave our county? 
• Learn more about the FQHC and how we can support this coming to our community. 
• Find out what foundations would be interested in helping with. 
• How many families do their well checks out of town?
• What keeps families from doing well checks?
• What is our capacity for families we can serve in county by pediatricians?