696 - Investigating Barriers to meet Head Start and Early Head Start Health Requirements with Reach Out and Read (ROR) Clinics

Publication Number: 696.5438

Michelle Quiroz Armenta, Oklahoma Childrens Hospital at OU Health, OKC, OK, United States; Yaqi Li, University of Oklahoma College of Medicine, OKC, OK, United States; Marny Dunlap, University of Oklahoma College of Medicine, Oklahoma City, OK, United States

Background: Head Start and Early Head Start (HS/EHS) are federally funded programs aimed at promoting children's development through early learning, health, and school readiness services. Yet, there are mandated health requirements that are difficult to meet.

Objective: To investigate barriers faced by families, medical providers, and HS/EHS sites in completing the HS/EHS health requirements.

Design/Methods: Medical providers from 22 ROR clinics were surveyed along with HS/EHS staff from 28 sites to assess barriers in completing the health requirements. 17 HS/EHS sites administered an anonymous survey to parents. Quantitative data was collected and analyzed.

Results: 192/334 medical providers responded. 15% reported usually/always discussing HS/EHS during well visits, 17% knew the eligibility criteria, and 39% provided referrals to HS/EHS. 52% of providers reported filling out health forms. Barriers to complete health forms included access to providers (37%), transportation (31%), forgetting forms (10%), and time off work (2%). Providers listed many barriers to filling out the form (Table 1). Comparison between residents and others (attendings/mid-levels) revealed the latter group had significantly greater knowledge of HS/EHS (Table 2) and also higher familiarity with both (Table 3).

245/297 HS/EHS staff responded, only 5% stating that medical providers always completed the health form. Barriers to form completion: parents losing forms (61%), lack of available appointments (10%), unavailability of the PCP (7%), time constraints (7%), and transportation (4%). HS/EHS staff also faced challenges in collaborating with medical providers, including inability to reach them (28%) and not receiving faxed paperwork (24%). Staff identified the biggest challenges of fulfilling health requirements: completing entire health form (33%), obtaining blood work (24%), and dental screening (10%).

Of 114 parents surveyed, 95% found it always/usually easy to find a doctor for their child, and 97% could always/usually get their doctor to fill out health forms. Reported barriers to medical care for their child included time away from work (37%), scheduling conflicts (26%), transportation (5%), finding a provider (4%), and other (22%).

Conclusion(s): Many medical providers were unfamiliar with HS/EHS and unaware of the health screen or eligibility requirements but expressed an interest in learning more. Few HS/EHS staff reported that the health forms were always filled out entirely to meet the requirement. Notably, the most significant barriers identified by parents and providers did not align.

Table 1


Table 2. Residents versus others knowledge of HS/EHS


Table 3. Residents versus others awareness of HS/EHS