P3B366: Prescribing Play in Pediatric Well-child Visits

Background: Play is widely accepted as essential for social, emotional, and cognitive development in early childhood. In addition, play with a present, loving caregiver can support resilience in children and buffer the effects of toxic stress. Interventions that promote play within pediatric care settings are greatly needed as play promotion is crucial for the development of young children, particularly from traditionally underserved populations. The Prescription for Play (P4P) program is a national play promotion program delivered by pediatric providers during routine wellness exams for children 18-36 months. The P4P program offers a free toy kit to patients and their caregivers along with other educational materials. This presentation will focus on an evaluation of the P4P program coupled with case examples of the program being implemented in clinical practice.

Methods: This program evaluation utilizes a mixed-methods multi-site case study design across 5 geographically diverse Federally Qualified Health Centers (FQHCs) in the US to assess the process and outcome measures of the intervention. Interviews (n=15) with care team members and observations (n=28) of well-child check (WCC) visits were conducted after sites began implementing the program to assess implementation fidelity. Ongoing data collection of surveys with caregivers seek to assess their play behaviors and attitudes measured with the constructs of the Integrated Behavior Model to evaluate the short-term outcomes of the program, with over 100 surveys thus far.

Results: Data collection is still ongoing until September 2023, but preliminary results from observations and interviews reflect positive reception of the program among caregivers, children, providers, and other care team members. In the majority of observations where patients had the P4P kit opened, patients were enthusiastic and engaged in creative play during their WCC visit. Through observations and care team interviews, case data emphasized the importance of effective workflows in order to implement the program as intended. Across sites, the P4P kits assisted in illustrating the importance of play to caregivers, helped patients feel more comfortable, and were used as developmental surveillance tools by providers during visits. Additionally, preliminary analysis of caregiver survey data indicates P4P encouraged behavioral intentions of caregivers’ to engage in play with their children.

Conclusion: This multisite program evaluation suggests that play promotion in pediatric well-child visits through the P4P program is feasible and potentially beneficial. Positive reception of and fidelity to the P4P program model across sites indicates P4P is a feasible strategy to embed play promotion into WCC visits. Additionally, preliminary data demonstrates limited changes to behavioral intentions among caregivers indicating the program potentially influences caregivers to play with their children more frequently. Further research into follow-up visits as well as a longitudinal analysis of developmental factors would offer further insights into the long-term outcomes of the intervention.