针对有发育问题的低收入、种族多样化学龄前儿童的家庭导航的可行性、可接受性和初步有效性
Feasibility, Acceptability, and Preliminary Effectiveness of Family Navigation for Low-income Ethnoracially Diverse Preschoolers with Developmental Concern.
作者信息
Smith Teresa, Burkett Karen, Pickler Rita, Bowers Katherine, Weber Stephanie, Trenkamp Elizabeth, Heeman Anna, Stanton-Chapman Tina, Copeland Kristen, Froehlich Tanya
机构信息
Division of Developmental and Behavioral Pediatrics, Division of Behavior Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, College of Nursing, University of Cincinnati, Cincinnati, OH, USA.
出版信息
J Racial Ethn Health Disparities. 2025 Sep 16. doi: 10.1007/s40615-025-02556-w.
OBJECTIVE
To assess for feasibility, acceptability, and preliminary effectiveness of an ethnoracially-matched family navigation intervention aimed at reducing barriers to developmental evaluations for preschoolers with developmental concern attending Head Start.
METHODS
Fifty-eight parents of Head Start preschoolers who were identified as at risk for developmental delay were assigned using stratified block random sampling to the family navigation intervention (n = 28) and 30 controls (usual care). Key outcomes included the percentage of children who completed the planned intervention visits, satisfaction with the intervention, and the proportion of children guided by family navigators who completed developmental evaluations.
RESULTS
Of the 28 families, 21 parents completed the family navigation intervention visits. The intervention sample was diverse, including 57% Black, 24% White, and 19% Latino(a) parents. Ninety percent of Head Start educators (n = 18) and 100% of healthcare providers (n = 6) were satisfied with the intervention. Parents qualitatively reported that they valued the advocacy support from the family navigators and navigators (n = 7) valued their role in "giving back." Sixty-six percent of the intervention group were seen by a healthcare provider to discuss developmental concerns showing preliminary effectiveness for completion of healthcare evaluations. However, there was no significant difference between those in the intervention and control group completing Head Start recommended evaluations, and over half of all participants were not referred for educational evaluations.
CONCLUSION
Results support the feasibility, acceptability, and preliminary effectiveness of an ethnoracially matched family navigation intervention to reduce barriers to developmental healthcare evaluations for preschoolers at risk for developmental delays.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03499405; Date of Registration: April 9, 2018.
目的
评估一项种族匹配的家庭导航干预措施的可行性、可接受性和初步效果，该干预旨在减少参加“启智计划”且有发育问题的学龄前儿童在发育评估过程中遇到的障碍。
方法
采用分层整群随机抽样法，将58名被确定有发育迟缓风险的“启智计划”学龄前儿童的家长分为家庭导航干预组（n = 28）和30名对照组（常规护理）。主要结局包括完成计划干预访视的儿童百分比、对干预的满意度，以及由家庭导航员指导并完成发育评估的儿童比例。
结果
28个家庭中，21名家长完成了家庭导航干预访视。干预样本具有多样性，包括57%的黑人、24%的白人以及19%的拉丁裔家长。90%的“启智计划”教育工作者（n = 18）和100%的医疗服务提供者（n = 6）对干预感到满意。家长们定性报告称，他们重视家庭导航员的支持，而导航员（n = 7）重视自己“回馈社会”的角色。66%的干预组儿童接受了医疗服务提供者的检查以讨论发育问题，这显示出在完成医疗评估方面的初步效果。然而，干预组和对照组在完成“启智计划”推荐评估方面没有显著差异，超过一半的参与者未被转介进行教育评估。
结论
结果支持了种族匹配的家庭导航干预措施在减少发育迟缓风险学龄前儿童发育医疗评估障碍方面的可行性、可接受性和初步效果。
试验注册
ClinicalTrials.gov标识符：NCT03499405；注册日期：2018年4月9日。
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