170 - Identifying Barriers to Early Head Start and Head Start Enrollment

Poster Number: 170
Publication Number: 170.316

Trista Vancuren, Oklahoma Childrens Hospital at OU Health, Edmond, OK, United States; Marny Dunlap, OUHSC, OKC, OK, United States

Background: Head Start and Early Head Start (HS/EHS) are federally funded programs that promote children’s development through services that support early learning, health, and school readiness. EHS/HS have mandated health requirements including a well visit. Frequent well child checks (WCC) during the first years of life put providers in a unique position to introduce early childhood programs such as HS/EHS.

Objective: Our study investigated barriers encountered by families, primary care providers, and HS/EHS directors and family advocates in the Oklahoma City region in completing the WCC.

Design/Methods: Medical providers, including residents, at five University Clinics were surveyed as well as HS/EHS directors and family health advocates from 16 HS/EHS sites to assess barriers encountered in completing the health care requirements. Sunbeam Family Services administered an anonymous survey to 275 parents and data was shared with the research team. Quantitative and qualitative data were collected. Chi square tests were used to test for significant differences between groups.

Results: Of 86 providers surveyed, 53 responded (62%). Majority of providers ask about child care during health visits, but only 13% usually or always ask about HS/EHS. Many resident providers are unfamiliar with HS/EHS and the enrollment criteria. Completing the health form is burdensome to 24% of providers and 55% report it would be easier to submit a copy of the child’s WCC documentation. Of 45 HS/EHS providers surveyed, 22 responded (49%). Majority (64%) report providers usually/always completely fill out health forms. 82% are aware WCC documentation can be accepted in place of the health form. Many perceive difficulty scheduling a WCC as a barrier parents experience. Of 275 parents surveyed, 114 responded (41%). Majority rarely/never have trouble finding a doctor for their child or scheduling a WCC (93% and 92%, respectively). The most frequent responses to barriers in completing a WCC were time away from work (67%), difficulty obtaining an appointment that works with their schedule (39%), and transportation (14%).  Conclusion(s): Many providers are unfamiliar with HS/EHS programs and their requirements, especially residents. Many would prefer submitting WCC documentation, and most HS/EHS personnel are aware this is an acceptable option. Interestingly, most parents denied difficulty obtaining visits for WCC despite it being a perceived barrier by HS/EHS personnel. Opportunities for intervention include educating medical providers about benefits and requirements of HS/EHS and options for submitting required health information.
Table 1: Medical Provider Respondents
Table 2: Provider UnfamiliarityMore residents than faculty and nurse practitioners are unfamiliar with EHS/HS.