Understanding Barriers to Early Intervention Services for Preterm Infants: Lessons From Two States
| Autor: | Alison A. Little, Alejandra Barrero-Castillero, Brian K. Corwin, Karen Kamholz, C. Jason Wang |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Parents Referral Developmental Disabilities South Carolina Psychological intervention Staffing Infant Premature Diseases Health Services Accessibility Article Grounded theory Young Adult Nursing Intensive care Early Intervention Educational Humans Infant Very Low Birth Weight Outpatient clinic Medicine Chronic care business.industry Infant Newborn Infant Focus Groups Middle Aged Focus group Massachusetts Pediatrics Perinatology and Child Health Female business Infant Premature |
| Zdroj: | Academic Pediatrics. 15:430-438 |
| ISSN: | 1876-2859 |
| DOI: | 10.1016/j.acap.2014.12.006 |
| Popis: | Objective To explore existing barriers and challenges to Early Intervention (EI) referral, enrollment, and service provision for very low birth weight (VLBW; Methods We conducted 10 focus groups with parents of VLBW children (n = 44) and 32 interviews with key informants from EI (n = 7), neonatal intensive care units (n = 17), and outpatient clinics (n = 8) at 6 sites in 2 states. We used grounded theory to identify themes about gaps in services. Results Both parents and providers found EI helpful. However, they also identified gaps in the current EI system at the levels of eligibility, referral, family receptivity, and service provision and coordination with medical care. Inadequate funding and variable procedures for evaluation may affect children's eligibility. Referrals can be missed as a result of simple oversight or communication failure among hospitals, EI, and families; referral outcomes often are not formally tracked. Families may not be receptive to services as a result of wariness of home visits, social stressors, denial about potential developmental delays, or lack of understanding of the benefits of EI. Once a child is deemed eligible, services may be delayed or terminated early, and EI providers may have little specialized training. Communication and coordination with the child's medical care team is often limited. Conclusions Systemic barriers, including funding and staffing issues, state and federal regulations, and communication with families and medical providers, have led to gaps in the EI system. The chronic care model may serve as a framework for integrating community-based interventions like EI with medical care for VLBW children and other vulnerable populations. |
| Databáze: | OpenAIRE |
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