Abstract
As an initial step in mitigating documented health inequities in diverse families’ early intervention (EI) program access and utilization, this study measured EI program information accessibility with evidence-based health literacy assessment tools.
Primary Author and Speaker: Cathy Leslie
Additional Authors and Speakers: Maria Angelica Linton, Taylor Delosh
Contributing Authors: Jillian Crehan, Lindsay Rosenfeld
Individuals with Disabilities Education Act Part C early intervention (EI) services improve health outcomes for infants and toddlers with developmental delays (Litt, 2018), but low income and minority families have inequitable access to EI services (McManus et al., 2020). Diverse parents with low health literacy report barriers when accessing EI services (Jimenez, 2013), including inaccessible written materials. This research study asked: ‘Are EI materials provided by Massachusetts Department of Public Health (MDPH) throughout the EI process accessible for families with various health literacy levels?’ A quantitative descriptive research design was used. Inclusion criteria included materials for families posted on MDPH EI website and related to EI access or services. Accessibility variables included clarity, understandability, actionability, and reading grade level. EI materials (n = 10 EI handouts, n = 6 EI forms) were assessed with 3 health literacy tools: CDC Clear Communication Index (CDC, 2019) measured clarity; Patient Education Materials Assessment Tool assessed understandability and actionability; and Oleander Readability Software determined average reading grade level. Based on descriptive statistical analysis, 100% of sample materials did not score in an acceptable score range for clarity, understandability, actionability, or reading grade level. Current MDPH EI materials are not accessible and represent a barrier to parents attempting to access needed EI services for their child. New EI materials should be created with user testing with parents of children with developmental delays. This study can positively impact occupational therapy (OT) practice in any setting as an example of OTs using health literacy tools that are evidence-based, publicly available, and require no specialized training to improve the accessibility of health information. As OTs committed to health equity, ensuring health information is accessible supports vulnerable patients.
Litt, J. S., Glymour, M. M., Hauser-Cram, P., Hehir, T., & McCormick, M. C. (2018). Early Intervention Services Improve School-age Functional Outcome Among Neonatal Intensive Care Unit Graduates. Academic Pediatrics, 18(4), 468–474. https://doi.org/10.1016/j.acap.2017.07.011
McManus, B. M., Richardson, Z., Schenkman, M., Murphy, N. J., Everhart, R. M., Hambidge, S., & Morrato, E. (2020). Child characteristics and early intervention referral and receipt of services: A retrospective cohort study. BMC Pediatrics, 20(84), 1-10. https://doi.org/10.1186/s12887-020-1965-x
Jimenez, M. E., Barg, F. K., Guevara, J. P., Gerdes, M., & Fiks, A. G. (2013). The impact of parental health literacy on the early intervention referral process. Journal of Health Care for the Poor and Underserved, 24(3), 1053–1062. https://doi.org/10.1353/hpu.2013.0141
Centers for Disease Control and Prevention. (2019). The CDC clear communication index: A tool for developing and assessing CDC public communication products. https://www.cdc.gov/ccindex/pdf/clear-communication-user-guide.pdf