Preemie Project
Purpose
The Preemie Project was a comprehensive intervention developed to address the complex personal and health care problems faced by infants born prematurely, and their families, in San Mateo County. A collaborative assembly of service providers sought to enhance coordination of care, facilitate access to early intervention services, and increase family support of these infants. Achievement of these aims is a necessary step toward the improvement of health, development, education, and social outcomes for children born prematurely.
Funders
First 5 San Mateo County
Participants
Children born at less than 37 weeks gestation with additional risk factors were enrolled in the project. They were followed until 54 months of age or the project’s end. We are now reviewing the data on their development and service utilization.
Members of multiple agencies met monthly to review cases in which the coordination across agencies would improve outcomes for children and families. The participants included Golden Gate Regional Center; California Children Service Medical Therapy Unit; Lucile Packard Children’s Hospital; San Mateo County Health Department and Family Health; Early Head Start and Head Start; Legal Aid Society of San Mateo County; and others.
Findings/presentations/publications
A total of 266 children born prematurely were enrolled and served by the Preemie Project between 2001 and 2007. The enrollment numbers demonstrate the sustained success of the project in contacting and recruiting participant families.
Low Birth Weight |
||
| SMC (2004) Number (% of 1-Year Total) |
PP (2001-2007) Number (% of 6-Year Total) |
|
| Children with Low Birth Weight | ||
| White | 245 (36.7%) | 108 (40.6%) |
| Asian/PI | 170 (25.5%) | 30 (11.3%) |
| Latino | 193 (28.9%) | 92 (34.6%) |
| African American | 32 (4.8%) | 12 (4.5%) |
| Multiracial | --- | 5 (1.9%) |
| Other/Unknown | 27 (4.0%) | 19 (6.8%) |
| Total | 667 | 266 |
Services available to children born prematurely in San Mateo County distribute across four major categories.
- Early intervention services that include developmental monitoring (EI-DM)
- Average length of EI/DM services - delivered over 18.8 months
- Average intensity of EI/DM services - 5.2 service hours
- Early intervention services that include treatment (EI-TX) as defined by Early Intervention rehabilitation services and infant programs (i.e., occupational, physical, and speech/language therapy)
- Average length of EI/TX services - delivered over 17.9 months
- Average intensity of EI/TX services - 106.1 service hours
- Motor therapy (MOT) services
- Average length of MOT services - delivered over 27.0 months
- Average intensity of MOT services - 60.9 service hours
- Resource management and family support (RM) services, including care and case management
- Average length of RM services - delivered over 25.4 months
- Average intensity of RM services - 28.3 service hours
Understanding what services are available, Preemie Project children can be sorted by level of risk at the time of NICU discharge.
- Documented Problem: 33 children (12.4%) who appear eligible for EI/TX services at the time of NICU discharge
- High Risk: 125 children (47.0%) who appear eligible for EI/DM services at the time of NICU discharge
- Low Risk: 108 children (40.6%) who appear ineligible for EI/TX or EI/DM services at the time of NICU discharge
Preemie Project children are approximately 18 months of age at the time of the Toddler Visit. At this point in time, we see different predictive patterns. With regard to language and cognitive outcomes, sociodemographic variables – child gender and maternal education – appear to have greatest predictive power. In contrast, with regard to psychomotor and adaptive behavior outcomes, biomedical (discharge status) and service variables appear to have greatest predictive power. Regression findings indicate that child gender and maternal education level were the only significant predictors of language outcomes as measured by PLS Total score at the Preschool Visit. These results show that female children and children whose mothers completed more education tend to score higher on the PLS.
Maternal education level was the only significant predictor of verbal cognitive outcomes as measured by the WPPSI-III Verbal score. Again, results show that children whose mothers completed more education tend to score higher on the WPPSI-III Verbal scale.
Preemie Project children are approximately 54 months of age at the time of the Pre-K Visit. At this latest point in time, the impact of sociodemographic variables overwhelms any effect of biomedical or service hour variables. Thus, with regard to language, verbal/performance/general cognitive ability, and adaptive behavior, sociodemographic variables – child gender and maternal education – appear to have greatest predictive power.
