611 - Family Navigation to Reduce Disparities in Early Intervention Access

Poster Number: 611
Publication Number: 611.402

James Guevara, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Ellen McQuaid, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Ellie R. Segan, Children's Hospital of Phildelphia, Bordentown, PA, United States; Marsha Gerdes, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Roy Wade, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Jeannette Newman, Philadelphia Infant Toddler Early Intervention, Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, United States; Sara Molina-Robinson, Public Health Management Corp. (PHMC), Philadelphie, PA, United States; Katherine Yun, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Kate E. Wallis, Perelman School of Medicine at the University of Pennsylvania, PHILADELPHIA, PA, United States; Knashawn H. Morales, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: Developmental delays disproportionately affect impoverished minority children which leads to racial disparities in accessing early intervention (EI) services. The Individuals with Disabilities Act (IDEA) mandates EI services be made available to children with identified delays, however, only half of at-risk children initiate and complete referrals for EI services. Lack of initiation and referral completion may be due to misconceptions about EI services and logistical barriers that impede participation.

Objective: To examine whether a family navigation program serving predominantly low-income, African-American families would improve EI referral completion among young children with developmental delays.

Design/Methods: Children age < 30 months with developmental delays who were referred to a county EI program from 6 urban pediatric practices were eligible for participation. Children were randomized to family navigation (a multicomponent intervention consisting of education, motivational interviewing, and problem solving), or usual care (consisting of an electronic referral sent by the child's pediatrician to the county EI agency). Parents completed study measures related to EI service use over 3 months. Differences in EI referral completion between groups were assessed using intention-to-treat analysis.

Results: 357 eligible children were enrolled and randomized to family navigation (n=183) or usual care (n=174). Most (94%) completed the 3-month follow-up. Children were primarily male (67%), African-American (67%), and with a family income < $55,000 (76%). The mean age in both groups was 21 months. [Table 1] There were no differences in the proportion of children who initiated EI intake between groups. [Table 2] However, a greater proportion of children who received family navigation completed multidisciplinary evaluations (MDE 50% vs. 38%, p=0.02) than children in the usual care group. There were no differences in eligibility for EI services (68% vs. 71%, p=0.84) or initiation of EI services (58% vs. 65%, p=0.32) among those who completed MDE between groups.

Conclusion(s): In a population of urban predominantly African-American children, a family navigation program working in conjunction with a county EI agency improved EI referral completion among young children referred for developmental delays. These results suggest that family navigation assistance can reduce racial disparities in EI access.