Weyers Simone, Götz Simon
Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Dec;67(12):1384-1393. doi: 10.1007/s00103-024-03955-w. Epub 2024 Oct 6.
Early childhood intervention is intended to systematically network and customise support services, particularly for socio-economically disadvantaged families. The programmes are universal or selective, but the evidence on their effectiveness is limited.
The aims of this study were to exemplary analyse whether participants in early childhood intervention services had better development than non-participants using the school entry examination (SEE) as well as to discuss to what extent the SEE can be used to assess the impact of early childhood intervention services.
We analysed three typical offers of early childhood intervention services (family education; Zukunft für Kinder (ZfK); Kita-U) in relation to full vaccination coverage and age-appropriate development at U9. Data from 4579 Düsseldorf first graders were included. Propensity score matching was used to calculate percentage differences (average treatment effect on the treated; ATT) in terms of immunisation coverage and development between comparable intervention and control groups.
All programmes are associated with a slightly increased probability of full vaccination protection (ATT 2.1 for family education; 2.5 for ZfK; 5.3 for Kita-U). Family education is also associated with a slightly higher probability of age-appropriate development (ATT 1.6), while the probability of age-appropriate development is lower for participants in ZfK (-10.1) and Kita‑U (-4.5).
The evaluation of early childhood intervention, especially selective services, is a methodological challenge due to confounding and suitable comparison groups. However, the SEE could be a framework for impact analyses under specific conditions.
幼儿期干预旨在系统地建立支持服务网络并进行定制，特别是针对社会经济弱势家庭。这些项目具有普遍性或选择性，但关于其有效性的证据有限。
本研究的目的是通过入学考试（SEE），以范例方式分析接受幼儿期干预服务的参与者是否比未参与者有更好的发展，并讨论SEE在多大程度上可用于评估幼儿期干预服务的影响。
我们分析了三种典型的幼儿期干预服务（家庭教育；儿童未来（ZfK）；幼儿园强化班（Kita-U））与U9时的全程疫苗接种覆盖率和适龄发育情况的关系。纳入了来自杜塞尔多夫的4579名一年级学生的数据。倾向得分匹配用于计算可比干预组和对照组在免疫接种覆盖率和发育方面的百分比差异（对治疗组的平均治疗效果；ATT）。
所有项目都与全程疫苗接种保护概率略有增加相关（家庭教育的ATT为2.1；ZfK为2.5；Kita-U为5.3）。家庭教育还与适龄发育的概率略高相关（ATT为1.6），而ZfK（-10.1）和Kita-U（-4.5）的参与者适龄发育的概率较低。
由于混杂因素和合适的对照组，幼儿期干预尤其是选择性服务的评估是一项方法学挑战。然而，在特定条件下，SEE可能是影响分析的一个框架。
