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Birth and maternal characteristics associated with early vs. late enrollment in Early Intervention services

Karen M. Clements, ScD1, Wanda Barfield, MD, MPH2, Milton Kotelchuck3, Kimberly Lee, MD, MS4, and Nancy Wilber, EdD1. (1) Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington St, 5th Floor, Boston, MA 02108, 617-624-5596, karen.clements@state.ma.us, (2) MA Department of Pubic Health, ASSETS, 250 Washington St., 5th floor, Boston, MA 02111, (3) Boston University, 715 Albany Street, T5W, Boston, MA 02118-2526, (4) Division of Newborn Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Rose 3, Boston, MA 02215

Background: Early Intervention (EI) provides multi-disciplinary services to infants and toddlers with established developmental delays and those at risk for delay. Examining characteristics associated with EI enrollment at different time points may identify groups for whom enrollment is delayed.

Objective: Identify birth and maternal characteristics associated with EI enrollment during the first, second, and third years of life using population-based data.

Methods: The Pregnancy and Early Life Longitudinal Data Set contains birth and hospital discharge records of infants born in Massachusetts in 1998-1999 linked to records from the state’s EI program. Logistic regression is used to identify variables associated with EI enrollment 1,2, and 3 years from birth.

Results: Of all MA births (N = 158,582), 13.1% enrolled in EI, with 4.4% enrolled in the first, 4.0% in the second, and 4.7% in the third year of life. Birth, maternal, and prenatal/perinatal characteristics all predicted first year enrollment. The strongest predictors were birthweight < 1500 g (OR = 5.7, 95% CI 5.0-6.6) and diagnosis at birth of EI-eligible medical condition (OR = 3.9, 95% CI 2.8-4.2). Male sex (OR = 1.9, 95% CI 1.8-1.9) and Hispanic maternal race (OR = 1.5, 95% CI 1.4-1.7) were strongest predictors of second-year enrollment. Predictors of third-year enrollment were similar to those of second-year enrollment.

Conclusion: While birth risks are strongly associated with early enrollment, demographic characteristics more strongly predict later enrollment. Whether later enrollment among males and Hispanics is appropriate or represents a delay in enrollment is still to be determined.

Learning Objectives: At the conclusion of the session, the participant will be able to

Keywords: Evaluation, Infant Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Topics in MCH Data and Epidemiology

The 132nd Annual Meeting (November 6-10, 2004) of APHA