The early years of a child’s life provide a key foundation for lifelong health, education, social-emotional functioning and economic productivity. Understanding how to support young children and their families through primary care, early care and education, and other community services, are important goals for child health services research.
Several CDI faculty are actively engaged in community-partnered projects to promote healthy development of children from birth to 5 years of age, and to improve systems of care that serve young children and their families. Current projects include:
Clinical Partnerships with 211: A New Model for Universal Early Childhood Developmental Screening and Care Coordination in Vulnerable Populations
Funder: Robert Wood Johnson Foundation, Public Health Services and Systems Research
Principal Investigators: Paul Chung, MD, MS, PI; Bergen Nelson, MD, MS, Co-PI
This project tests the effectiveness of an innovative partnership between primary care child health clinical services and telephone-based early childhood developmental screening and care coordination through 211 Los Angeles County (211LA). The project addresses several important research questions related to public health services and systems, by bridging public health and clinical systems to examine a cross-sector relationship that has the potential to:
We are testing this innovative partnership using a randomized-controlled trial design, randomly assigning approximately 300 families of young children at the clinic to call 2-1-1 or receive usual well-child care. We will then assess whether or not children receive age-appropriate developmental and Autism screening using structured, validated tools, what referrals are made to evaluation and intervention services, what services are received, as well as families' experiences of care. This model has tremendous potential for dissemination to 2-1-1 call centers and child health care centers nation-wide, together serving millions of vulnerable children and families.
This is an institutional career development award administered through the Clinical and Translational Science Institute (NIH/National Center for Advancing Translational Science (NCATS) UL1TR000124). While professional recommendations exist for child health providers to identify and refer the 5-10% of young children with developmental disabilities, there is a much larger group (25-30% of young children) without developmental delays but with important risks and family concerns, which predict worse long-term educational and health outcomes.
This project aims to develop tools that clinicians can use to systematically identify this middle-risk group of children and link families to effective support services. We have used secondary data analyses to develop risk prediction models for poor school readiness among 2-year-olds without developmental delays, and will translate these models into a feasible clinical decision support (CDS) tool, integrating the risk assessment and referral options into an electronic health record. Dr. Nelson will seek external funding through a K23 award from the NICHD, to support additional development and pilot testing of the CDS tool.
Early Childhood Linkages to Wellness
Funder: First 5 LA, through the LA Trust for Children’s Health
Principal Investigators: Bergen Nelson, MD, MS, PI; Tumaini R. Coker, MD, MBA, Senior Investigator
The LA Trust for Children’s Health coordinates a network of school-based health and wellness centers, operated by community clinics on LAUSD school campuses. The Early Childhood Linkages to Wellness (ECLW) project is an effort funded by First 5 LA, to build the capacity of 6 of those wellness centers and the communities they serve, to support and make linkages for families with children from birth to 5. The project includes case managers and community outreach workers who link families to the wellness centers and support families of young children through a range of referrals, parent workshops, outreach and developmental screening events. The project also includes training for wellness center providers and other school health providers in delivering high-quality clinical care for young children. Drs. Nelson and Coker are leading an evaluation of the ECLW project that will describe its accomplishments and reach, through tracking services provided and understanding parents’ experiences of care.
Funded by the LA Trust for Children’s Health through a grant from First 5 LA and evaluated by the Early Childhood Linkages to Wellness project, this Bright Futures-based training series is delivered by UCLA Pediatricians to health care providers caring for children ages 0-5 at LAUSD Wellness Centers are available on our Videos page.
Health Care Institute: Health Education and Health Promotion in Head Start
Funder: Johnson & Johnson Foundation
Principal Investigators: Ariella Herman, PhD, PI; with Paul Chung, MD, MS, Co-I, and Bergen Nelson, MD, MS, Co-I
Years: Ongoing, through the UCLA Anderson School
The Health Care Institute (HCI) at UCLA’s business school, the Anderson School of Management, has trained Head Start and Early Head Start programs across the country to implement health education and health promotion programs on a variety of prevention-oriented topics. Drs. Chung and Nelson have been partners with HCI since 2009, supporting evaluations of their programs, starting with an obesity prevention program for Head Start children, parents, and staff, called “Eat Healthy, Stay Active!” The HCI training model has been used to disseminate a wide range of health education and health promotion programs in Head Start agencies, including common childhood illnesses, vaccinations, oral health, prenatal care, and mental health. HCI is a core partner, along with the AAP, in the National Center on Early Childhood Health and Wellness, which provides training and technical assistance to early care and education programs across the U.S.