The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

Maternal interaction style, reported experiences of care, and pediatric health care utilization

U.S. immunization and well child-care rates are below desired levels with lower income individuals being at higher risk for receiving inadequate care. To enhance the understanding of motivating factors to health care utilization, this study explored relationships between a mother\u27s interaction style (secure, anxious, avoidant), her reported experiences with pediatric health care and her child\u27s utilization of pediatric health care. Participants included 126 US-born, English-speaking women with an infant 12 to18 months of age. Linear regression analyses found no bivariate associations between maternal interaction style and reported experiences of care. Poisson regression analyses measured associations of maternal interaction style, reported experiences of care, and moderating variables with health care visits and immunizations received. Main effect models found no associations between maternal interaction style and reported experiences of care. Significant associations were identified between provider ratings and sick visits. There were no associations between provider office ratings and utilization rates. When interaction style and provider/provider office ratings were included in the model, high provider ratings (P\u3c.05) and high anxious interaction scores (p\u3c.0001) were associated with more sick visits while higher avoidant interaction style scores (p\u3c.01) were associated with decreased use of sick visits. Multivariate modeling identified provider rating (p\u3c.05) and anxious interaction score (p\u3c.01) as main effects, child\u27s health rating as a confounder, as well as target child being mother\u27s first, WIC/Healthy Start participation, maternal bonding and feelings about going to the doctor acting as moderators to associations between interaction style and sick/follow-up visits. Secure interaction style scores were associated with increased use of emergency department visits, controlling for the confounding effects of maternal bonding and the moderating effects of child\u27s health status and maternal age. Findings indicate that, in some cases, maternal interaction style is associated with how and when mothers access health care for their children. The confounders and moderators identified also highlight the need for more understanding regarding what motivates individuals. Finally, there were racial and ethnic differences including higher rates of avoidant interaction styles in Black, non-Hispanic mothers. Predicting health care utilization patterns will help better target the specific needs of mothers and ultimately improve health outcomes