Bowers Katherine, Folger Alonzo T, Zhang Nanhua, Sa Ting, Ehrhardt Jennifer, Meinzen-Derr Jareen, Goyal Neera K, Van Ginkel Judith B, Ammerman Robert T
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
Matern Child Health J. 2018 Apr;22(4):494-500. doi: 10.1007/s10995-017-2415-8.
Objectives To determine whether participation in a home visiting program increases and expedites utilization of early intervention services for suspected developmental delays. Methods Children participating in Every Child Succeeds (ECS), a large home visiting (HV) program serving greater Cincinnati, between 2006 and 2012, were propensity score matched to a sample of children identified from birth records who did not receive services from ECS. Data were linked to early intervention (EI) data acquired from the Ohio Department of Health. Descriptive statistics were employed to evaluate success of the matching. Chi square and log-rank tests evaluated whether the proportion of children accessing EI and the time to EI services differed for families participating in HV compared to eligible children not participating. Logistic regression and Cox proportional hazards regression modeled the associations. Results Among 3574 HV and 3574 comparison participants, there was no difference in the time to EI service utilization; however a higher percentage of HV participants accessed services. Overall, 6% of the HV group and 4.3% of the comparison group accessed services (p = 0.001). Modeling revealed an odd ratio = 1.43 [95% confidence interval (CI) 1.16-1.78, p value = 0.001] and hazard ratio = 1.42 [95% CI 1.15-1.75, p value = 0.001]. Differences in utilization were greatest directly after birth and between approximately 2 and 3 years. Conclusions for Practise Participation in home visiting was associated with greater utilization of EI services during two important developmental time points, demonstrating that home visiting may serve as an important resource for facilitating access to early intervention services.
确定参与家访项目是否会增加并加快对疑似发育迟缓儿童的早期干预服务利用。方法:2006年至2012年间,参与“每个孩子都成功”(ECS)项目(一项为大辛辛那提地区服务的大型家访项目)的儿童,通过倾向得分匹配,与从出生记录中识别出的未接受ECS服务的儿童样本进行匹配。数据与从俄亥俄州卫生部获取的早期干预(EI)数据相链接。采用描述性统计评估匹配的成功情况。卡方检验和对数秩检验评估参与家访的家庭与未参与的符合条件儿童相比,获得EI服务的儿童比例以及获得EI服务的时间是否存在差异。逻辑回归和Cox比例风险回归对关联进行建模。结果:在3574名家访参与者和3574名对照参与者中,获得EI服务的时间没有差异;然而,家访参与者获得服务的比例更高。总体而言,家访组中有6%的儿童获得了服务,对照组中有4.3%的儿童获得了服务(p = 0.001)。建模显示优势比 = 1.43 [95%置信区间(CI)1.16 - 1.78,p值 = 0.001],风险比 = 1.42 [95% CI 1.15 - 1.75,p值 = 0.001]。出生后直接以及大约2至3岁之间的利用差异最大。实践结论:参与家访与在两个重要发育时间点对EI服务的更高利用率相关,表明家访可能是促进获得早期干预服务的重要资源。