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Patient navigation to facilitate early intervention referral completion among poor urban children
James P Guevara1, Brooke Rothman1, Elizabeth Brooks1
1PolicyLab: Center to Bridge Research, Practice, and Policy, The Children's Hospital of Philadelphia.
Insights
A patient navigation program improved early intervention (EI) referrals for at-risk children in an urban setting. The study found the program feasible and promising for increasing EI participation among diverse populations.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Early intervention (EI) programs are crucial for child development, yet participation rates remain low among eligible children.
- Diverse, at-risk populations face unique barriers to accessing essential developmental services.
- Patient navigation offers a potential solution to bridge the gap between referral and service completion.
Purpose of the Study:
- To assess the feasibility of a novel patient navigation program for early intervention (EI) referrals.
- To evaluate the outcomes of patient navigation on EI referral completion rates.
- To examine the program's effectiveness in a diverse, urban population of at-risk children.
Main Methods:
- A 6-month prospective study in an urban pediatric clinic.
- Patient navigators engaged families, provided education on child development and EI, and facilitated evaluations.
- Eligibility criteria included children under 34 months with suspected developmental delays referred for EI.
Main Results:
- 53 eligible children enrolled; the population was diverse in race, insurance, and caregiver education/literacy.
- 79.2% of referred families completed the EI referral process.
- 81.0% of those completing referrals were eligible for EI services, with no demographic/literacy disparities observed.
Conclusions:
- Patient navigation is a feasible approach to enhance EI referrals in diverse urban settings.
- The program demonstrated promising results in improving EI referral completion.
- Further research is warranted to confirm the long-term impact and scalability of patient navigation.
Introduction:
Few eligible children participate in early intervention (EI) programs. The objective of this study was to determine feasibility and outcomes of a novel patient navigation program on EI referrals among a diverse group of at-risk children.
Methods:
During a 6-month period, a patient navigator was assigned to an urban pediatric clinic to engage families, provide education on early child development and EI, and assist families with completing multidisciplinary evaluations. Families were eligible to participate if they spoke English, had a child <34 months old with a suspected developmental delay, and were referred to EI for evaluation. Families completed measures of demographics, language preference, and the Newest Vital Sign, a validated literacy measure. Outcomes on completion of EI referrals were obtained from the county EI provider.
Results:
Of 88 EI referrals during the study period, 53 patients were eligible and enrolled. Patients were predominantly male, racially diverse, on public health insurance, with a mean age of 18.4 months. Most caregivers of patients had less than a high school education, spoke a non-English language at home, and had limited literacy. Forty-two families (79.2%) completed a referral, and 34 (81.0%) of those were eligible for EI services. There were no significant differences in demographic, language, or literacy measures between those who completed and did not complete EI referrals.
Discussion:
A patient navigation program to facilitate EI referrals was feasible in a diverse urban patient population. Preliminary results of the patient navigation program on EI referral completion were promising and warrant further study. (PsycINFO Database Record
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