Increasing Medicaid child health screenings: the effectiveness of mailed pamphlets, phone calls, and home visits.
OBJECTIVE
A randomized controlled trial was conducted to test the effectiveness and cost effectiveness of three outreach interventions to promote well-child screening for children on Medicaid.


METHODS
In rural North Carolina, a random sample of 2053 families with children due or overdue for screening was stratified according to the presence of a home phone. Families were randomly assigned to receive a mailed pamphlet and letter, a phone call, or a home visit outreach intervention, or the usual (control) method of informing at Medicaid intake.


RESULTS
All interventions produced more screenings than the control method, but increases were significant only for families with phones. Among families with phones, a home visit was the most effective intervention but a phone call was the most cost-effective. However, absolute rates of effectiveness were low, and incremental costs per effect were high.


CONCLUSIONS
Pamphlets, phone calls, and home visits by nurses were minimally effective for increasing well-child screenings. Alternate outreach methods are needed, especially for families without phones.
Selby-Harrington
M
M
School of Nursing, University of North Carolina at Greensboro 27412-5001, USA.
Sorenson
J R
JR
Quade
D
D
Stearns
S C
SC
Tesh
A S
AS
Donat
P L
PL
D000328:Adult; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003159:Community-Institutional Relations; D003362:Cost-Benefit Analysis; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D009657:North Carolina; D010174:Pamphlets; D012423:Rural Health; D013689:Telephone; D014481:United States