Effect of a URI-related educational intervention in early head start on ED visits.
OBJECTIVE
To evaluate the effectiveness of an educational intervention to decrease pediatric emergency department (PED) visits and adverse care practices for upper respiratory infections (URI) among predominantly Latino Early Head Start (EHS) families.


METHODS
Four EHS sites in New York City were randomized. Families at intervention sites received 3 1.5-hour education modules in their EHS parent-child group focusing on URIs, over-the-counter medications, and medication management. Standard curriculum families received the standard EHS curriculum, which did not include URI education. During weekly telephone calls for 5 months, families reported URI in family members, care sought, and medications given. Pre- and post-intervention knowledge-attitude surveys were also conducted. Outcomes were compared between groups.


RESULTS
There were 154 families who participated (76 intervention, 78 standard curriculum) including 197 children <4 years old. Families were primarily Latino and Spanish-speaking. Intervention families were significantly less likely to visit the PED when their young child (age 6 to <48 months) was ill (8.2% vs 15.7%; P = .025). The difference remained significant on the family level (P = .03). These families were also less likely to use an inappropriate over-the-counter medication for their <2-year-old child (odds ratio, 0.29; 95% confidence interval, 0.09-0.95; 12.2% vs 32.4%, P = .034) and/or incorrect dosing tool for their <4-year-old child (odds ratio, 0.24; 95% confidence interval, 0.08-0.74; 9.8% vs 31.1%; P < .01). The mean difference in Knowledge-Attitude scores for intervention families was higher.


CONCLUSIONS
A URI health literacy-related educational intervention embedded into EHS decreased PED visits and adverse care practices.
Division of Child and Adolescent Health, Department of Pediatrics, Department of Population and Family Health and New York-Presbyterian Hospital, New York, New York mss2112@columbia.edu.
Melissa S
MS
Stockwell
Division of Child and Adolescent Health, Department of Pediatrics, Department of Population and Family Health and New York-Presbyterian Hospital, New York, New York.
Marina
M
Catallozzi
Department of Epidemiology, Mailman School of Public Health, and School of Nursing, Columbia University, New York, New York; and.
Elaine
E
Larson
Department of Population and Family Health and.
Carmen
C
Rodriguez
Division of Child and Adolescent Health, Department of Pediatrics, New York-Presbyterian Hospital, New York, New York.
Anupama
A
Subramony
Department of Population and Family Health and.
Raquel
R
Andres Martinez
Division of Child and Adolescent Health, Department of Pediatrics.
Emelin
E
Martinez
Division of Child and Adolescent Health, Department of Pediatrics.
Angela
A
Barrett
Division of Child and Adolescent Health, Department of Pediatrics, New York-Presbyterian Hospital, New York, New York.
Dodi
D
Meyer
D002675:Child, Preschool; D003479:Curriculum; D004363:Drug Utilization; D018479:Early Intervention, Educational; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education; D006630:Hispanic or Latino / Q000193:education*; D006801:Humans; D007223:Infant; D008297:Male; D009519:New York City; D004366:Nonprescription Drugs / Q000627:therapeutic use; D063046:Patient Medication Knowledge; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D014505:Urban Population; D014600:Utilization Review
D004366:Nonprescription Drugs
Early Head Start; health literacy; upper respiratory infections