# Reducing Disparities in Early Intervention Use: The Opening Doors to Early Intervention Study

> **NIH NIH R01** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $125,000

## Abstract

Project Summary
Developmental delays are frequently encountered among young children and disproportionately affect
impoverished minority children leading to disparities in early child development. To promote healthy child
development, the Individuals with Disabilities Education Act (IDEA) mandated early intervention (EI) services
be made available to young children with delays, but only half of at-risk children initiate and complete EI
services. As a result, many at-risk children may not receive needed services to improve their development. To
foster initiation and completion of EI services, we developed the Opening Doors to Early Intervention Program,
a patient navigation intervention based on the Health Belief Model and targeted to at-risk urban minority
children. An initial pilot study among at-risk children demonstrated feasibility and generated promising results.
Therefore, this Community-Based Participatory Research application proposes to test the effectiveness of this
program in a single urban county using a randomized trial design. The specific aims are to 1) determine the
effectiveness of the Opening Doors to early Intervention Program on child developmental status and EI referral
and services use, 2) assess whether parent engagement in early intervention mediates the effects of the
program, and 3) explore whether the home learning environment, parental health literacy, and poverty
moderate the effects of the program. This application addresses health disparities in early childhood by testing
an intervention designed to improve participation rates in EI among urban minority children and their families
on measures of early child development and EI services use. Three to four primary care pediatric clinics that
provide care to this diverse urban community will be recruited to participate. Three hundred sixty children who
are less than 30 months of age and have been identified as developmentally at-risk and referred for EI services
at participating clinics will be randomized to receive the Opening Doors to Early Intervention Program or usual
care. Urban minority parents who have previously participated in EI services will be trained as patient
navigators to provide education, motivation, and assistance for families with initiation and completion of EI
referrals and services. Clinicians and Child Find staff will provide usual care consisting of developmental
screening and referrals without assistance. Information on participant demographic characteristics, health
literacy, and the home learning environment at baseline; parent engagement and EI referral and services
completion at 3, 6, 9, and 12 months; and child development at 12 months will be collected during scheduled
study visits. Differences in outcomes between intervention and control participants will be compared using
intention-to-treat analysis. Findings from this comparative effectiveness study can be disseminated to similar
large urban counties across the U.S. to inform Child Fin...

## Key facts

- **NIH application ID:** 10497897
- **Project number:** 3R01MD011598-05S1
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** JAMES P GUEVARA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $125,000
- **Award type:** 3
- **Project period:** 2018-04-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10497897

## Citation

> US National Institutes of Health, RePORTER application 10497897, Reducing Disparities in Early Intervention Use: The Opening Doors to Early Intervention Study (3R01MD011598-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10497897. Licensed CC0.

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