The goal of the federally sponsored and state operated Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program is optimal health for low-income children by disease prevention and early detection and treatment of health problems. If EPSDT eligible children are not participating in the Program, outreach and casefindings are important means of increasing the number of eligible children who receive services such as periodic health assessments. Public health nursing (PHN) field services consisting of telephone contacts and home visits, as allowable outreach and casefinding methods within EPSDT, have not been adequately examined as to effectiveness. This study will experimentally test the impact of such services as the intervention (independent variable) on the rate of health assessments (dependent variable) received in children categorized in public agency records as EPSDT eligible non-participants. From the pool of EPSDT eligible non-participants, subjects will be randomly assigned to one experimental group (E1) that will receive PHN telephone contacts; a second experimental group (E2) will receive PHN home visits; and the control group (C) will receive no PHN services during the study period. Four PHNs will apply the intervention to the experimental groups within a four-month period using a protocol for consistency. Health assessments obtained by all subjects will be tracked during the subsequent eight-month period by county and state disbursement records. The rate of health assessments received by subject groups will be analyzed to determine the outcome of the nursing intervention. The results of the study are expected to provide information regarding the impact of PHN service modalities on efforts to increase EPSDT program participation. The ultimate objective is to identify PHN nursing actions that effectively facilitate the participation of EPSDT eligible non-participants in the federally sponsored preventive child health program.
