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Published on: June 19, 2019
Participation in Home Visitation is Associated with Higher Utilization of Early Intervention
Katherine Bowers1,2, Alonzo T Folger3,4, Nanhua Zhang3,4
1Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA. katherine.bowers@cchmc.org.
Insights
Home visiting programs increase early intervention service use for developmental delays. While not speeding up access, participation significantly boosted service utilization, especially after birth and around ages two to three.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Early intervention services are crucial for children with developmental delays.
- Home visiting programs aim to support families and improve child outcomes.
- Understanding the impact of home visiting on early intervention access is vital.
Purpose of the Study:
- To determine if home visiting programs increase and expedite early intervention (EI) service utilization for suspected developmental delays.
- To analyze the association between participation in the Every Child Succeeds (ECS) home visiting program and EI service access.
Main Methods:
- Propensity score matching was used to compare children in the ECS home visiting program with a control group.
- Data were linked with early intervention records from the Ohio Department of Health.
- Chi-square, log-rank tests, logistic regression, and Cox proportional hazards regression were employed to analyze differences in EI utilization and timing.
Main Results:
- No significant difference was found in the time to early intervention service utilization between groups.
- A higher percentage of home visiting participants accessed EI services (6%) compared to the control group (4.3%).
- Logistic and Cox regression models showed a significant association between home visiting and increased EI utilization (OR=1.43, HR=1.42).
Conclusions:
- Home visiting participation is associated with greater utilization of early intervention services.
- These benefits were most pronounced at key developmental periods: shortly after birth and between ages two and three.
- Home visiting programs can serve as a valuable resource for facilitating access to essential early intervention services.
Abstract:
Objectives To determine whether participation in a home visiting program increases and expedites utilization of early intervention services for suspected developmental delays. Methods Children participating in Every Child Succeeds (ECS), a large home visiting (HV) program serving greater Cincinnati, between 2006 and 2012, were propensity score matched to a sample of children identified from birth records who did not receive services from ECS. Data were linked to early intervention (EI) data acquired from the Ohio Department of Health. Descriptive statistics were employed to evaluate success of the matching. Chi square and log-rank tests evaluated whether the proportion of children accessing EI and the time to EI services differed for families participating in HV compared to eligible children not participating. Logistic regression and Cox proportional hazards regression modeled the associations. Results Among 3574 HV and 3574 comparison participants, there was no difference in the time to EI service utilization; however a higher percentage of HV participants accessed services. Overall, 6% of the HV group and 4.3% of the comparison group accessed services (p = 0.001). Modeling revealed an odd ratio = 1.43 [95% confidence interval (CI) 1.16-1.78, p value = 0.001] and hazard ratio = 1.42 [95% CI 1.15-1.75, p value = 0.001]. Differences in utilization were greatest directly after birth and between approximately 2 and 3 years. Conclusions for Practise Participation in home visiting was associated with greater utilization of EI services during two important developmental time points, demonstrating that home visiting may serve as an important resource for facilitating access to early intervention services.
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