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:
A Randomized, Controlled Trial of a Telephone-Based Developmental Care Coordination System
Funder: NIH - NICHD
Principal Investigators: Paul Chung, MD, MS, PI; Bergen Nelson, MD, MS, Co-PI; Amanda Gulsrud, PhD, Co-PI
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. This 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 are testing the effectiveness of 211LA in 1) increasing referrals for developmental evaluation, 2) increasing the numbers of children deemed eligible for services, and 3) increasing the number of children actually receiving interventions. We are enrolling 662 children ages 1-3 years who receive well-child care at one of our partner clinic sites. Outcomes include referrals to early intervention evaluations, eligibility for intervention services, and receipt of services. 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.
Familias Unidas Ninos Sanos (FUNS)
Principal Investigator: Alma Guerero, MD, MPH
Child obesity disproportionately impacts young Latino children and has important implications for later adulthood weight and health problems. In-person parent-focused obesity prevention and control interventions are effective in establishing healthy weight behaviors and weight outcomes for young children, including Latino children. Widespread dissemination in healthcare and community settings pose several challenges including family participation barriers of time, cost, transportation, and English proficiency. This is a community-based feasibility study of a mobile phone childhood obesity intervention for family caregivers of Latino preschool-aged children. A four-week program was developed in English and Spanish to target mothers, fathers, and grandmothers of preschool children. The program combined weekly one-hour in-person sessions with web-based interactive text messages consisting of embedded video clips and tips for evidence-based and age-appropriate behavior changes. The study evaluated whether the intervention could:
Health Care Institute: Health Education and Health Promotion in Head Start
Funder: Johnson & Johnson Foundation
Principal Investigators: Rebecca Dudovitz, MD, MSHS; Ariella Herman, PhD, PI; with Paul Chung, 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.
The Relationship of Parenting Behaviors and Children’s Social Emotional Development among Latino Children: The Cultural Appropriateness of Commonly Used Measures of Parenting Behaviors
Principal Investigator: Alma Guerero, MD, MPH
Young Latino children, more specifically Mexican-heritage children, display robust social emotional outcomes on par with White children. Notable disparities, however, exist in Latino-White cognitive trajectories during early childhood. Identifying the ethnic-specific parenting behaviors that shape the robust social emotional developmental outcomes in Latino children may provide the parenting strategies to impact cognitive and other aspects of Latino child development. The objective is to examine the parenting behaviors, using measures of the Two-Bag Test, associated with social emotional outcomes in young children among racially and ethnically diverse families participating in the The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B).