Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities

Societal and structural inequities have resulted in longstanding health care disparities among Black, Latino/a/e, and low-income preschool children with developmental delays and disabilities (PCw/DD), depriving them of educational and therapeutic services that improve future academic, economic, and...

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Main Authors: Tina L. Schuh, Kathleen R. Diviak, Sarai Coba-Rodriguez, Emily Pela, Raphael Kinney, Michael L. Berbaum, Amanda Klemas, Kruti Acharya, Molly Martin, Reshma Shah
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Contemporary Clinical Trials Communications
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451865424001595
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author Tina L. Schuh
Kathleen R. Diviak
Sarai Coba-Rodriguez
Emily Pela
Raphael Kinney
Michael L. Berbaum
Amanda Klemas
Kruti Acharya
Molly Martin
Reshma Shah
author_facet Tina L. Schuh
Kathleen R. Diviak
Sarai Coba-Rodriguez
Emily Pela
Raphael Kinney
Michael L. Berbaum
Amanda Klemas
Kruti Acharya
Molly Martin
Reshma Shah
author_sort Tina L. Schuh
collection DOAJ
description Societal and structural inequities have resulted in longstanding health care disparities among Black, Latino/a/e, and low-income preschool children with developmental delays and disabilities (PCw/DD), depriving them of educational and therapeutic services that improve future academic, economic, and health outcomes. To address this issue, we developed Preschool and Me (PreM), a community-clinical linkage (CCL) implemented within healthcare settings serving historically marginalized communities. This novel CCL, an educational-medical linkage model, aims to increase access to school-based services for PCw/DD. Combining key components of CCLs with a personalized medical-education care plan and remote navigator support, PreM targets multiple levels of influence impacting access to school-based therapeutic and educational services. We will utilize a hybrid effectiveness-implementation approach in two models of real-world service delivery conditions. Participants (n = 320) will be randomized to either 6 months of PreM or a waitlist control arm beginning the intervention after a 6-month delay. Our specific aims are to test the effectiveness of PreM on access to school-based services as well as health service outcomes; examine mediators of intervention effects using a mixed-methods approach; and explore social determinants of health as potential moderators. We will simultaneously conduct an implementation evaluation. The results of this study have the potential to support effective implementation of CCL models within pediatric clinical settings serving historically marginalized communities which can be utilized to improve health outcomes for families and their children with a range of health conditions.
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spelling doaj-art-0af9a89dbf4e42ecb7b37038f4c7cb572025-01-12T05:25:30ZengElsevierContemporary Clinical Trials Communications2451-86542025-02-0143101412Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communitiesTina L. Schuh0Kathleen R. Diviak1Sarai Coba-Rodriguez2Emily Pela3Raphael Kinney4Michael L. Berbaum5Amanda Klemas6Kruti Acharya7Molly Martin8Reshma Shah9Institute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USADepartment of Educational Psychology, University of Illinois, Chicago, IL, 60607, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USAEquip for Equality, Chicago, IL, 60602, USADepartment of Pediatrics, College of Medicine, University of Illinois, Chicago, IL, 60612, USA; Department of Disability and Human Development, University of Illinois, Chicago, IL, 60612, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USA; Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL, 60612, USAInstitute of Health Research and Policy, University of Illinois, Chicago, IL, 60608, USA; Department of Pediatrics, College of Medicine, University of Illinois, Chicago, IL, 60612, USA; Corresponding author. 1747 W Roosevelt Street, Chicago, IL, 60608, USA.Societal and structural inequities have resulted in longstanding health care disparities among Black, Latino/a/e, and low-income preschool children with developmental delays and disabilities (PCw/DD), depriving them of educational and therapeutic services that improve future academic, economic, and health outcomes. To address this issue, we developed Preschool and Me (PreM), a community-clinical linkage (CCL) implemented within healthcare settings serving historically marginalized communities. This novel CCL, an educational-medical linkage model, aims to increase access to school-based services for PCw/DD. Combining key components of CCLs with a personalized medical-education care plan and remote navigator support, PreM targets multiple levels of influence impacting access to school-based therapeutic and educational services. We will utilize a hybrid effectiveness-implementation approach in two models of real-world service delivery conditions. Participants (n = 320) will be randomized to either 6 months of PreM or a waitlist control arm beginning the intervention after a 6-month delay. Our specific aims are to test the effectiveness of PreM on access to school-based services as well as health service outcomes; examine mediators of intervention effects using a mixed-methods approach; and explore social determinants of health as potential moderators. We will simultaneously conduct an implementation evaluation. The results of this study have the potential to support effective implementation of CCL models within pediatric clinical settings serving historically marginalized communities which can be utilized to improve health outcomes for families and their children with a range of health conditions.http://www.sciencedirect.com/science/article/pii/S2451865424001595Health disparityCommunity-clinical linkageDevelopmental disabilities and delaysHealthcare accessImplementation scienceSocial determinants of health
spellingShingle Tina L. Schuh
Kathleen R. Diviak
Sarai Coba-Rodriguez
Emily Pela
Raphael Kinney
Michael L. Berbaum
Amanda Klemas
Kruti Acharya
Molly Martin
Reshma Shah
Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
Contemporary Clinical Trials Communications
Health disparity
Community-clinical linkage
Developmental disabilities and delays
Healthcare access
Implementation science
Social determinants of health
title Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
title_full Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
title_fullStr Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
title_full_unstemmed Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
title_short Preschool and Me: Educational-clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
title_sort preschool and me educational clinical linkage to improve health equity for children with developmental delays and disabilities from historically marginalized communities
topic Health disparity
Community-clinical linkage
Developmental disabilities and delays
Healthcare access
Implementation science
Social determinants of health
url http://www.sciencedirect.com/science/article/pii/S2451865424001595
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