Article

Effect of a clinic-based referral system to head start: a randomized controlled trial.

Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Mass 02118, USA.
JAMA The Journal of the American Medical Association (impact factor: 30.03). 09/2004; 292(8):968-71. DOI:10.1001/jama.292.8.968
Source: PubMed

ABSTRACT Early childhood development programs such as Head Start have proven benefits for impoverished children. However, few physicians assist families with enrollment.
To test if a primary care-based intervention is efficacious in increasing Head Start attendance.
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.
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.
Head Start attendance by January 2004.
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.
Facilitating an initial connection to Head Start on families' behalf substantially increased Head Start attendance.

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Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

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Keywords

123 children analyzed
 
246 Head Start-eligible children
 
31 children
 
4 children
 
4 health clinics
 
4 years recruited
 
50 children
 
72 children
 
95% confidence interval [CI]
 
families' behalf
 
immunization record
 
impoverished children
 
initial connection
 
intervention group
 
physical examination form
 
physician referral letter
 
primary care-based intervention
 
study group
 
study personnel
 
waiting list
 

Michael Silverstein