University Honors

Well-child visits (WCVs) are central to pediatric preventive care, yet immigrant families in the United States experience disparities in access and quality of WCV care. Structural barriers, language discordance, and cultural incongruence contribute not only to missed visits but also to increased caregiver burden in care management. In this scoping review, we synthesized the evidence on barriers to and interventions to improve WCV access among immigrant families. Using a scoping review approach, we identified studies focused on WCV access among immigrant and underserved families. Studies were included if they addressed structural, cultural, and language barriers that influenced caregiver burden and access to WCVs. Nine studies met the inclusion criteria, where we then synthesized qualitative, randomized controlled, and other quantitative studies. Across the studies, we found that language and cultural differences emerged as common barriers for immigrant families. Even when families were able to attend WCVs, the quality of the visit still depended on communication quality, cultural alignment, and trust in the information and care provided. Many preventive care models were unfamiliar to first-generation parents, which led to uncertainty and dissatisfaction even after completing visits. In underserved communities, children experiencing overlapping barriers such as poverty, limited English proficiency, and insurance instability were less likely to report regular physician visits or an established source of care. In this review, we identified many barriers to access to WCVs that could be addressed in health systems to improve care, including navigating unfamiliar health systems, translating medical information, coordinating insurance, and reconciling collective family decision-making norms within an individualistic care model. Advancing access to well-child visits in underserved regions requires culturally responsive, equity-focused strategies that address structural and communication barriers within pediatric preventive care systems.