Effect of a URI-related educational intervention in early head start on ED visits
Melissa S Stockwell1, Marina Catallozzi2, Elaine Larson3
1Division of Child and Adolescent Health, Department of Pediatrics, Department of Population and Family Health and New York-Presbyterian Hospital, New York, New York mss2112@columbia.edu.
Insights
An educational intervention for upper respiratory infections (URIs) in Early Head Start (EHS) families reduced pediatric emergency department visits and improved medication safety. This health literacy program demonstrated significant positive outcomes for young children.
Area of Science:
- Pediatric Health
- Health Literacy
- Public Health Interventions
Background:
- Upper respiratory infections (URIs) are common in young children, leading to frequent healthcare utilization.
- Early Head Start (EHS) programs serve vulnerable populations, offering a platform for health education.
- Adverse care practices and unnecessary pediatric emergency department (PED) visits for URIs are significant concerns.
Purpose of the Study:
- To assess the efficacy of a health literacy educational intervention.
- To reduce pediatric emergency department visits for URIs.
- To decrease adverse care practices related to URI management in predominantly Latino EHS families.
Main Methods:
- Randomized trial across four EHS sites in New York City.
- Intervention group received three educational modules on URIs, over-the-counter (OTC) medications, and management.
- Data collected via weekly calls and pre/post knowledge-attitude surveys over five months.
Main Results:
- Intervention families showed significantly lower PED visit rates for ill young children (8.2% vs. 15.7%, P=.025).
- Reduced use of inappropriate OTC medications for children under 2 (12.2% vs. 32.4%, P=.034).
- Decreased use of incorrect dosing tools for children under 4 (9.8% vs. 31.1%, P<.01).
Conclusions:
- A URI health literacy intervention integrated into EHS effectively reduced PED visits.
- The educational program led to safer medication practices and improved URI care.
- Health literacy initiatives can positively impact healthcare utilization and child safety in EHS settings.
Objectives:
To evaluate the effectiveness of an educational intervention to decrease pediatric emergency department (PED) visits and adverse care practices for upper respiratory infections (URI) among predominantly Latino Early Head Start (EHS) families.
Methods:
Four EHS sites in New York City were randomized. Families at intervention sites received 3 1.5-hour education modules in their EHS parent-child group focusing on URIs, over-the-counter medications, and medication management. Standard curriculum families received the standard EHS curriculum, which did not include URI education. During weekly telephone calls for 5 months, families reported URI in family members, care sought, and medications given. Pre- and post-intervention knowledge-attitude surveys were also conducted. Outcomes were compared between groups.
Results:
There were 154 families who participated (76 intervention, 78 standard curriculum) including 197 children <4 years old. Families were primarily Latino and Spanish-speaking. Intervention families were significantly less likely to visit the PED when their young child (age 6 to <48 months) was ill (8.2% vs 15.7%; P = .025). The difference remained significant on the family level (P = .03). These families were also less likely to use an inappropriate over-the-counter medication for their <2-year-old child (odds ratio, 0.29; 95% confidence interval, 0.09-0.95; 12.2% vs 32.4%, P = .034) and/or incorrect dosing tool for their <4-year-old child (odds ratio, 0.24; 95% confidence interval, 0.08-0.74; 9.8% vs 31.1%; P < .01). The mean difference in Knowledge-Attitude scores for intervention families was higher.
Conclusions:
A URI health literacy-related educational intervention embedded into EHS decreased PED visits and adverse care practices.
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