CONTEXT: Early childhood development programs such as Head Start have proven benefits for impoverished children. However, few physicians assist families with enrollment. OBJECTIVE: To test if a primary care-based intervention is efficacious in increasing Head Start attendance. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of 246 Head Start-eligible children aged 0 through 4 years recruited in spring 2003 from 4 health clinics in Seattle, Wash. INTERVENTIONS: List of Head Start telephone contacts provided to families of all children and, for those in the intervention group, a computer-generated packet containing a physician referral letter (and a physical examination form and immunization record, if available) mailed directly to Head Start by study personnel. MAIN OUTCOME MEASURE: Head Start attendance by January 2004. RESULTS: The 123 children analyzed in each study group were similar at baseline. Overall, 72 children (29%) were successfully connected with Head Start (ie, actively attending or on a waiting list) by January 2004. Among the intervention group, 50 children (41%) were successfully connected with Head Start, contrasted with 22 (18%) in the control group (adjusted difference, 17%; 95% confidence interval [CI], 8%-27%). Among the intervention group, 31 children (25%) were actively attending Head Start, contrasted with 14 (11%) in the control group (adjusted difference, 12%; 95% CI, 3%-21%). Only 2 clinics contributed children to Head Start waiting lists. Among children from these clinics, 19 of 87 (22%) in the intervention group got onto a Head Start waiting list, vs 8 of 94 (9%) in the control group (adjusted difference, 13%; 95% CI, 5%-21%). To get 1 child either into Head Start or onto a waiting list, we needed to refer 4 children. CONCLUSION: Facilitating an initial connection to Head Start on families' behalf substantially increased Head Start attendance.
RCT Entities:
CONTEXT: Early childhood development programs such as Head Start have proven benefits for impoverished children. However, few physicians assist families with enrollment. OBJECTIVE: To test if a primary care-based intervention is efficacious in increasing Head Start attendance. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of 246 Head Start-eligible children aged 0 through 4 years recruited in spring 2003 from 4 health clinics in Seattle, Wash. INTERVENTIONS: List of Head Start telephone contacts provided to families of all children and, for those in the intervention group, a computer-generated packet containing a physician referral letter (and a physical examination form and immunization record, if available) mailed directly to Head Start by study personnel. MAIN OUTCOME MEASURE: Head Start attendance by January 2004. RESULTS: The 123 children analyzed in each study group were similar at baseline. Overall, 72 children (29%) were successfully connected with Head Start (ie, actively attending or on a waiting list) by January 2004. Among the intervention group, 50 children (41%) were successfully connected with Head Start, contrasted with 22 (18%) in the control group (adjusted difference, 17%; 95% confidence interval [CI], 8%-27%). Among the intervention group, 31 children (25%) were actively attending Head Start, contrasted with 14 (11%) in the control group (adjusted difference, 12%; 95% CI, 3%-21%). Only 2 clinics contributed children to Head Start waiting lists. Among children from these clinics, 19 of 87 (22%) in the intervention group got onto a Head Start waiting list, vs 8 of 94 (9%) in the control group (adjusted difference, 13%; 95% CI, 5%-21%). To get 1 child either into Head Start or onto a waiting list, we needed to refer 4 children. CONCLUSION: Facilitating an initial connection to Head Start on families' behalf substantially increased Head Start attendance.
Authors: Esther K Chung; Benjamin S Siegel; Arvin Garg; Kathleen Conroy; Rachel S Gross; Dayna A Long; Gena Lewis; Cynthia J Osman; Mary Jo Messito; Roy Wade; H Shonna Yin; Joanne Cox; Arthur H Fierman Journal: Curr Probl Pediatr Adolesc Health Care Date: 2016-04-18
Authors: Andrew F Beck; Alicia J Cohen; Jeffrey D Colvin; Caroline M Fichtenberg; Eric W Fleegler; Arvin Garg; Laura M Gottlieb; Matthew S Pantell; Megan T Sandel; Adam Schickedanz; Robert S Kahn Journal: Pediatr Res Date: 2018-05-23 Impact factor: 3.756