Date of Award

1-1-2012

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Marjorie Rosenthal

Abstract

Hypothesis: Children enrolled in an Early Head Start program providing child care health consultation services will demonstrate improved health status compared to a national sample of children with similar socio-economic background. Additionally, through the work of the Child Care Health Consultant, family day care providers will demonstrate improved compliance with health and safety regulations. Methods: In collaboration with All Our Kin, a logic model was developed at the start of the evaluation. The demographic and medical record files were reviewed for each Early Head Start participant. Data regarding access to care, screenings, and immunization history was compared to two publicly available, national datasets as well as studies of similar populations. Baseline data regarding adherence to several health and safety child care standards was gathered, with post-intervention data similarly collected at least five months later. Means and standard deviations for these regulations were calculated across participating providers. Statistical analysis was conducted using SPSS 19.0. Results: Forty-four children participated in the Early Head Start program. 100% of currently enrolled children were insured, compared to 90.4% of children in the dataset of similar age and economic status. Children in the Early Head Start program were also more likely to have received more seasonal flu vaccines than their peers (p<0.05). Eighty-four percent of children in the Early Head Start program have received screening for lead poisoning, compared to 28% of children in other Early Head Start programs around the country. Early Head Start providers showed the greatest improvements from baseline to post-intervention in the oral health recommendations from the American Academy of Pediatrics and American Public Health Association standards, but worsened regarding handwashing compliance. Conclusions: Early Head Start participants demonstrated improved health status for several access to care indicators, preventive screenings, and seasonal vaccinations. Through the child care health consultation program, providers have made significant gains in promoting oral health; additional opportunities for improvement exist in the areas of handwashing and infant / toddler diapering.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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