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A Randomized, Controlled Trial of a Telephone-Based Developmental Care Coordination System

基于电话的发育护理协调系统的随机对照试验

基本信息

批准号：
10379450
负责人：
PAUL J CHUNG
金额：
$ 44.55万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10379450
关键词：
5 year old Academy Address Advisory Committees Age American Appointment Birth Caring Child Child Behavior Checklist Child Care Child Health Clinic Clinical Cognitive Collaborations Community Services Control Groups Costs and Benefits Country County Data Development Developmental Delay Disorders Drops Early Intervention Effectiveness Eligibility Determination Employment Enrollment Ensure Equipment and supply inventories Evaluation Extravasation Failure Family Federally Qualified Health Center Gold Health Health Personnel Human Infrastructure Intervention Investigation Language Language Delays Lead Link Location Los Angeles Measures Medical Records Modeling Online Systems Outcome Outcome Measure Parents Participant Pediatrics Population Preventive service Process Provider Randomized Randomized Controlled Trials Recommendation Reporting Research Risk Series Services Site Speech Delay Structure System Systems Development Telephone Testing Time Training Uncertainty Visit Well Child Visits Work autism spectrum disorder base behavior measurement behavioral outcome care coordination care providers care systems child services cost cost estimate early childhood early screening effectiveness testing externalizing behavior follow-up group intervention high risk improved improved outcome innovation intervention program kindergarten member pediatrician prevent primary outcome program costs programs randomized controlled study screening service intervention service organization telephone-based tool treatment as usual voltage vulnerable community

项目摘要

PROJECT SUMMARY/ ABSTRACT Although universal early childhood developmental screening is recommended by the American Academy of Pediatrics, ample evidence suggests that child health providers are not meeting those recommendations, and many early developmental delays are being missed. Additional evidence suggests that both providers and parents struggle to navigate the early childhood developmental system of care, with few high-risk children actually getting referred, and fewer still ultimately receiving services. The gaps in care processes have created gaps in evidence linking developmental screening to developmental outcomes, leading the US Preventive Services Task Force to state that there is not enough evidence to recommend for or against universal screening for speech and language delays or Autism Spectrum Disorders. The proposed project is a randomized controlled trial of a telephone-based early childhood developmental care coordination system, in partnership with 2-1-1 Los Angeles County (211LA), part of a national network of 2-1-1 call centers covering 93% of the US population. We will test the effectiveness of 211LA in increasing referrals for developmental evaluation, increasing the numbers of children deemed eligible for services, and increasing the number of children actually receiving interventions. The trial will enroll 800 children ages 1-3 years who receive well-child care at one of 10 partner clinic sites. We will conduct developmental screening on all children using the Parental Evaluation of Developmental Status (PEDS) Online system, and randomize children 1:1 into intervention (connection to 211LA for developmental care coordination + usual care) or control (usual care alone, with developmental care coordination conducted by clinic staff). Primary outcomes will include referrals to early intervention evaluations, eligibility for intervention services, and receipt of services. We will measure these outcomes through parent report, medical record review, and 211LA data, at 6 months after enrollment. For children with elevated developmental risk based on the PEDS Online results, we will assess development using the gold-standard Brigance Inventory of Early Development III (Brigance), conducted at baseline and 24 months after enrollment. For all children, we will administer the language and cognitive subscales of the Brigance at baseline, 12 months and 24 months, to evaluate development over time in the two groups. We will measure behavioral outcomes for all children using the externalizing behavior subscale of the Child Behavior Checklist. Expected findings include higher rates of referrals, eligibility, and receipt of intervention services among intervention group participants, and greater developmental gains among children in the intervention group. We will also examine the costs of the program in relation to these outcomes, to estimate the costs and potential long-term benefits of this model. If effective, the model has the potential to disseminate rapidly throughout the 2-1-1 network and transform developmental care coordination in the US.

项目摘要/摘要