Effect of a Clinic-Based Referral System to Head Start: A Randomized Controlled Trial

A Randomized Controlled Trial

Studies have shown that when health professionals contact medical specialists on a patient's behalf, follow-up rates are improved. Few studies, however, have examined the effect of physician intervention on referrals to community services. This particular study considers the efficacy of facilitating contact between eligible low-income families and Head Start, a high quality pre-school program. Children were drawn from four community clinics in the Seattle area in early 2003. Families of children in the study were sent a contact list of Head Start agencies through the mail. Intervention children were given an additional package which included a physician referral letter and, where available, a physician examination form and the child's immunization record. This package also was mailed to Head Start personnel. The analysis included 123 children in the control group and 123 in the intervention group. Overall, 72 of the children in the study (29%) were either actively attending Head Start or on a waiting list by January 2004. Fifty children (41%) from the intervention group were either actively attending Head Start, or on a waiting list, contrasted with 22 (18%) from the control group. The researchers conclude that the intervention made a difference in promoting Head Start attendance and referrals.