J Health Care Poor Underserved. 2025;36(4):1445-1462. doi: 10.1353/hpu.2025.a975595.
ABSTRACT
Despite the critical role of well-child visits (WCVs) in preventive care, many Medicaid-enrolled children miss these appointments, leading to gaps in early intervention and immunization. Existing research has largely focused on either quantitative analyses of visit rates and predictors or qualitative insights into patient and provider experiences. This study employs a mixed-methods, community-based approach to examine barriers to WCV attendance among Medicaid-enrolled families in North Dakota who missed all WCVs in 2021. Through administrative data analysis (n=64,364), surveys (n=1,294), and focus groups (n=40), findings reveal structural, economic, and cultural obstacles, including cost concerns, lack of Medicaid transparency, and logistical challenges. Community-informed recommendations emphasize improved Medicaid communication, culturally responsive care, and enhanced appointment accessibility. Addressing these barriers could promote equitable access to WCVs, improve child health outcomes, and reduce disparities in preventive care for underserved populations.
PMID:41355651 | DOI:10.1353/hpu.2025.a975595
