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及时识别和转介有社会和环境风险的婴儿。

Timeliness of Early Identification and Referral of Infants with Social and Environmental Risks.

机构信息

Tufts Interdisciplinary Evaluation Research (TIER), Eliot-Pearson Department of Child Study and Human Development, Tufts University, 574 Boston Ave., Suite 106, Medford, MA, 02155, USA.

Massachusetts Department of Public Health, Bureau of Family Health and Nutrition, Boston, USA.

出版信息

Prev Sci. 2023 Jan;24(1):126-136. doi: 10.1007/s11121-022-01453-6. Epub 2022 Oct 22.

Abstract

The Early Intervention Parenting Partnerships (EIPP) program is a home visiting program that provides home visits, group services, assessments and screenings, and referrals delivered by a multidisciplinary team to expectant parents and families with infants who experience socioeconomic barriers, emotional and behavioral health challenges, or other stressors. The present study examines whether EIPP successfully meets its aims of screening families for social and environmental factors that may increase the risk of children's developmental delays and connect them to the larger statewide early intervention (EI) system relative to families with similar background characteristics who do not receive EIPP. Coarsened exact matching was used to match EIPP participants who enrolled between 2013 and 2017 to a comparison group of families identified from birth certificates. Primary study outcomes including EI referrals, evaluations, and service receipt for children from 3 months to 3 years were measured using EI program data. Secondary outcomes included EI referral source, EI eligibility criteria (e.g., presence of biological, social, or environmental factors that may increase later risk for developmental delay), and information on service use. Impacts were assessed by fitting weighted regression models adjusted for preterm birth and maternal depression and substance use. EIPP participants were more likely than the comparison group to be referred to, evaluated for, and receive EI services. EIPP facilitated the identification of EI-eligible children who are at risk for developmental delays due to social or environmental factors, such as violence and substance use in the home, child protective services involvement, high levels of parenting stress, and parent chronic illness or disability. EIPP serves as an entry point into the EI system, helping families attain the comprehensive supports they may need to optimize their well-being and enhance children's development.

摘要

早期干预亲子伙伴关系 (EIPP) 计划是一项家访计划,由多学科团队为经历社会经济障碍、情绪和行为健康挑战或其他压力的孕妇和有婴儿的家庭提供家访、小组服务、评估和筛查以及转介。本研究旨在检验 EIPP 是否成功实现了其目标,即为有社会和环境因素风险的家庭进行筛查,这些因素可能增加儿童发育迟缓的风险,并将他们与具有类似背景特征但未接受 EIPP 的家庭联系起来,从而纳入更大的全州早期干预 (EI) 系统。使用粗化精确匹配将 2013 年至 2017 年间入组的 EIPP 参与者与从出生证明中确定的对照组家庭进行匹配。主要研究结果包括从 3 个月到 3 岁的儿童的 EI 转介、评估和服务接受情况,使用 EI 项目数据进行测量。次要结果包括 EI 转介来源、EI 资格标准(例如,存在可能增加发育迟缓后期风险的生物、社会或环境因素)以及服务使用信息。通过拟合加权回归模型进行评估,这些模型调整了早产、产妇抑郁和物质使用等因素。与对照组相比,EIPP 参与者更有可能被转介、接受评估并获得 EI 服务。EIPP 有助于识别因社会或环境因素(如家庭中的暴力和物质使用、儿童保护服务介入、高水平的育儿压力以及父母慢性疾病或残疾)而面临发育迟缓风险的 EI 合格儿童。EIPP 是进入 EI 系统的切入点,帮助家庭获得他们可能需要的全面支持,以优化他们的幸福感并促进儿童的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9e8/9589561/3616eac398c4/11121_2022_1453_Fig1_HTML.jpg

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