Can Assigning a Patient Navigator Help Get Early Intervention for More Poor Urban Children?

Mom and child with doctor looking on

Most children who are eligible for early-intervention programs don't participate. The authors devised a novel program to help patients navigate the necessary steps. They investigated whether it would be feasible—and if it could increase these referrals among a diverse group of at-risk children.

For six months, a patient navigator was assigned to an urban pediatric clinic to engage families, provide education on early child development and early intervention, and help families complete multidisciplinary evaluations. Families were eligible to participate if they spoke English, had a child 34 months old or younger with a suspected developmental delay, and were referred to early intervention for evaluation. They provided information about their demographics and language preference, and completed the Newest Vital Sign, a validated literacy measure.

The county early-intervention provider reported the rates at which the early-interventon referrals were completed during the study period. Out of the 88 referrals, 53 patients were eligible and enrolled. The patients were racially diverse; they were mostly male and on public health insurance. Their average age was 18.4 months. Most of their caregivers had less than a high school education, spoke a non-English language at home, and had limited literacy.

Forty-two families (79.2%) completed a referral, and 34 (81.0%) of them were eligible for early-intervention services. There were no significant differences in demographic, language or literacy measures between those who completed and did not complete the referrals. A patient navigation program to facilitate early-intervention referrals was shown to be feasible in a diverse urban patient population. Preliminary results demonstrate that the patient-navigation program shows promise; it may raise the number of patients who complete early-intervention referrals. The approach warrants further study.

Read the article in Families, Systems, & Health


James P. Guevara, MD, MPH; Brooke Rothman, Elizabeth Brooks, Marsha Gerdes, Fayetta McMillon-Jones, Katherine Yun