Participation in Home Visitation is Associated with Higher Utilization of Early Intervention
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Participation in Home Visitation is Associated with Higher Utilization of Early Intervention Katherine Bowers1,2 · Alonzo T. Folger1,2 · Nanhua Zhang1,2 · Ting Sa1,2 · Jennifer Ehrhardt2,3 · Jareen Meinzen‑Derr1,2 · Neera K. Goyal4 · Judith B. Van Ginkel2 · Robert T. Ammerman2,5 Published online: 31 January 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018
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. Keywords Home visiting · Early intervention · Developmental delay
Significance * Katherine Bowers [email protected] 1
Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
2
Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH 45229, USA
3
Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
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Department of Pediatrics, Nemours AI/DuPont Hospital for Children and the Sidney Kimmel College of Medicine, Thomas Jefferson University, 833 Chestnut Street Suite 300, Philadelphia, PA 19107, USA
5
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA
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