Bergen B Nelson1,2,3, Lindsey R Thompson2,3, Patricia Herrera4, Christopher Biely2,3, Damaris Arriola Zarate2,3, Irene Aceves4, Ingrid Estrada5, Vincent Chan2, Cynthia Orantes6, Paul J Chung2,3,7,8. 1. Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia; bergen.nelson@vcuhealth.org. 2. Department of Pediatrics, University of California, Los Angeles Mattel Children's Hospital and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 3. University of California, Los Angeles Children's Discovery and Innovation Institute, Los Angeles, California. 4. 2-1-1 Los Angeles County, San Gabriel, California. 5. Clínica Monseñor Oscar A. Romero, Los Angeles, California. 6. Department of Pediatrics, School of Medicine, Loma Linda University, Loma Linda, California. 7. RAND Corporation, Santa Monica, California; and. 8. Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California.
Abstract
BACKGROUND AND OBJECTIVES: Despite professional guidelines to conduct universal early childhood developmental screening, primary care providers often struggle with early identification of developmental delays, referrals to interventions, and connecting families to services. In this study, we tested the efficacy of telephone-based developmental screening and care coordination through 2-1-1 Los Angeles County, which is part of a national network of call centers, compared with usual care alone. METHODS:Children ages 12 to 42 months old who receive well-child care at a community health center serving predominantly Hispanic families were recruited and randomly assigned to intervention and control groups. Families in the intervention group were connected with 2-1-1, in which a trained care coordinator conducted developmental screening over the phone using the Parental Evaluation of Development Status Online system and made referrals to intervention services on the basis of developmental risk. The 2-1-1 care coordinator then followed-up with families to assist with connections to evaluations and services. After 6 months, primary outcomes included the following: (1) percentage of children referred for developmental evaluation and intervention services and (2) percentage of children actually receiving services. RESULTS:One hundred and fifty-two children were randomly assigned to intervention (n = 77) and control (n = 75) groups. On the basis of intention-to-treat analyses, significantly more children assigned to the intervention group were referred (32% vs 9%; P = .001) and were receiving services (16% vs 1%; P = .002) within 6 months compared with children assigned to usual care alone. CONCLUSIONS:Telephone-based developmental screening and care coordination through 2-1-1 appears to be an effective approach for increasing the numbers of young children referred to, and receiving, intervention services for developmental delays.
RCT Entities:
BACKGROUND AND OBJECTIVES: Despite professional guidelines to conduct universal early childhood developmental screening, primary care providers often struggle with early identification of developmental delays, referrals to interventions, and connecting families to services. In this study, we tested the efficacy of telephone-based developmental screening and care coordination through 2-1-1 Los Angeles County, which is part of a national network of call centers, compared with usual care alone. METHODS:Children ages 12 to 42 months old who receive well-child care at a community health center serving predominantly Hispanic families were recruited and randomly assigned to intervention and control groups. Families in the intervention group were connected with 2-1-1, in which a trained care coordinator conducted developmental screening over the phone using the Parental Evaluation of Development Status Online system and made referrals to intervention services on the basis of developmental risk. The 2-1-1 care coordinator then followed-up with families to assist with connections to evaluations and services. After 6 months, primary outcomes included the following: (1) percentage of children referred for developmental evaluation and intervention services and (2) percentage of children actually receiving services. RESULTS: One hundred and fifty-two children were randomly assigned to intervention (n = 77) and control (n = 75) groups. On the basis of intention-to-treat analyses, significantly more children assigned to the intervention group were referred (32% vs 9%; P = .001) and were receiving services (16% vs 1%; P = .002) within 6 months compared with children assigned to usual care alone. CONCLUSIONS: Telephone-based developmental screening and care coordination through 2-1-1 appears to be an effective approach for increasing the numbers of young children referred to, and receiving, intervention services for developmental delays.
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