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Cited by 21Child and Adolescent HealthAdolescent and Pediatric HealthcareTelemedicine and Telehealth Implementation

Telephone-based developmental screening and care coordination through 2-1-1: a randomized trial

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Nelson, Bergen B., Thompson, Lindsey R., Herrera, Patricia, Biely, Christopher, Arriola Zarate, Damaris, Aceves, Irene, Estrada, Ingrid, Chan, Vincent +2 more·2019·Pediatrics
DOI 10.1542/peds.2018-1064PMC PMC6564070
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Abstract

BACKGROUND AND OBJECTIVES: Despite professional guidelines to conduct universal early childhood developmental screening, primary care providers often struggle with early identification of developmental delays, referrals to interventions, and connecting families to services. In this study, we tested the efficacy of telephone-based developmental screening and care coordination through 2-1-1 Los Angeles County, which is part of a national network of call centers, compared with usual care alone. METHODS: Children ages 12 to 42 months old who receive well-child care at a community health center serving predominantly Hispanic families were recruited and randomly assigned to intervention and control groups. Families in the intervention group were connected with 2-1-1, in which a trained care coordinator conducted developmental screening over the phone using the Parental Evaluation of Development Status Online system and made referrals to intervention services on the basis of developmental risk. The 2-1-1 care coordinator then followed-up with families to assist with connections to evaluations and services. After 6 months, primary outcomes included the following: (1) percentage of children referred for developmental evaluation and intervention services and (2) percentage of children actually receiving services. RESULTS: One hundred and fifty-two children were randomly assigned to intervention (n = 77) and control (n = 75) groups. On the basis of intention-to-treat analyses, significantly more children assigned to the intervention group were referred (32% vs 9%; P = .001) and were receiving services (16% vs 1%; P = .002) within 6 months compared with children assigned to usual care alone. CONCLUSIONS: Telephone-based developmental screening and care coordination through 2-1-1 appears to be an effective approach for increasing the numbers of young children referred to, and receiving, intervention services for developmental delays.

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  • 211LA in 2009 developed a specialized, telephone-based developmental screening and early childhood care coordination model that demonstrated high levels of DB risk among callers to 2-1-1.

    “The Information and Referral Federation of Los Angeles County (211LA), in 2009 developed a specialized, telephone-based developmental screening and early childhood care coordination model that demonstrated high levels of DB risk among callers to 2–1-1.17”

    From Sustained Effectiveness of a 211 Call Center With Early Childhood Care Coordination (2025) · cites this paper as [17]

  • Early results of the prior randomized trial demonstrated that the intervention increased referral to and connections with developmental services and early care and education 6 months after study enrollment.

    “Early results demonstrated the intervention increased referral to and connections with developmental services as well as early care and education (ECE), 6 months after study enrollment.17”

    From Sustained Effectiveness of a 211 Call Center With Early Childhood Care Coordination (2025) · cites this paper as [17]

  • The target sample was 662, determined based on an assumption that approximately 20% of families would be lost to follow-up each year, and chosen so that detectable differences would be within the bounds of the confidence intervals from the pilot data.

    “Our target sample was 662. This sample size was determined based on an assumption that approximately 20% of families enrolled in the study would be lost to follow-up each year, and chosen so that detectable differences would be within the bounds of the confidence intervals from the pilot data.17”

    From Sustained Effectiveness of a 211 Call Center With Early Childhood Care Coordination (2025) · cites this paper as [17]

    The Prospective RCT Study Results (p. 6) report 152 children enrolled in the cited trial, while the Discussion (p. 8) notes substantial loss to follow-up. Neither passage, nor searches for “662,” a 20% annual loss assumption, and pilot-data confidence intervals, addresses the citing authors’ target sample or how they calculated it. (LLM, conf=0.75)

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Authors
Nelson, B. B., Thompson, L. R., Herrera, P., Biely, C., Arriola Zarate, D., Aceves, I., Estrada, I., Chan, V., Orantes, C., & Chung, P. J.
Affiliations
  • University of California, Los Angeles (US)
  • 2-1-1 Los Angeles County, San Gabriel, California;
  • Department of Pediatrics, University of California, Los Angeles Mattel Children’s Hospital and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California;
  • Clínica Monseñor Oscar A. Romero, Los Angeles, California;
  • Loma Linda University (US)
  • RAND Corporation (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2019-04-01
Volume
143
Issue
4
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2018-1064
PMC
PMC6564070
OpenAlex
W2924836425
Cited by
21
References
29
Citations by year
2026: 3 · 2025: 6 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 3
FWCI
3.07
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (UL1TR001881)
  • National Center for Advancing Translational Sciences
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD092406)
  • Clinical and Translational Science Institute, University of California, Los Angeles (UL1 TR001881)
Topics
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
care coordination, developmental delay, early childhood, community health centers, Latino families, access to services, Los Angeles County
MeSH terms
Ambulatory Care Facilities, California, Developmental Disabilities, Child, Preschool, Female, Humans, Infant, Male, Mass Screening, Patient Care Planning, Reference Values, Telephone, Program Evaluation, Incidence, Program Development, Risk Assessment, Early Medical Intervention

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