{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:07:59Z","timestamp":1784221679903,"version":"3.55.0"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Disparities in early intervention (EI) use are well documented. We sought to determine the effects of family navigation (FN) on EI services use and child development among low-income, racially diverse children with suspected developmental delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a randomized controlled trial at 6 pediatric practices in a large urban community. Children who were aged younger than 30 months, had a gestational age of more than 35\u00a0weeks, had parents who spoke English or Spanish, and were referred to Part C EI were eligible. Children were randomized to FN or usual care and followed for 12 months. The main outcome measures were multidisciplinary evaluation (MDE) and EI service initiation and duration obtained from county EI program administrative files and Bayley-3 developmental scores. We examined differences among groups using intention-to-treat logistic and Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We randomized 358 eligible children and followed 305 (85%) for 12 months. Children were predominantly Black with family incomes of less than $55\u2009000. Overall, 257 (72%) completed an MDE, and 195 (54%) initiated services. Children who received FN had greater odds of MDE completion (adjusted odds ratio, 2.1; 95% CI, 1.2\u20133.5) and greater EI service initiation (64.4% vs 54.7%; P\u2009=\u2009.02) than children who received usual care. The average duration of EI services and Bayley-3 scores did not differ among groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>We found that an FN program improved EI referral completion and services initiation but not EI duration or child development among a population of predominantly low-income urban Black children. Implementation of FN programs in similar minoritized communities may reduce disparities in access to EI services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-070970","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:03:01Z","timestamp":1773014581000},"source":"Crossref","is-referenced-by-count":1,"title":["Family Navigation to Reduce Disparities in Early Intervention Services: A Randomized Controlled Trial"],"prefix":"10.1542","volume":"157","author":[{"given":"James P.","family":"Guevara","sequence":"first","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"2Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"3Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"Gerdes","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie","family":"Segan","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Yun","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wallis","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Newman","sequence":"additional","affiliation":[{"name":"4Department of Behavioral Health and Intellectual Disabilities Services, City of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Wade","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Molina-Robinson","sequence":"additional","affiliation":[{"name":"5Childlink, Public Health Management Corporation, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungwon","family":"Min","sequence":"additional","affiliation":[{"name":"1Department of Pediatrics, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knashawn H.","family":"Morales","sequence":"additional","affiliation":[{"name":"2Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"1","key":"2026071612513211100_r1","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.1542\/peds.2011-2663","article-title":"The lifelong effects of early childhood adversity and toxic stress","volume":"129","author":"Shonkoff","year":"2012","journal-title":"Pediatrics."},{"issue":"21","key":"2026071612513211100_r2","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1001\/jama.2009.754","article-title":"Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention","volume":"301","author":"Shonkoff","year":"2009","journal-title":"JAMA."},{"issue":"12","key":"2026071612513211100_r3","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1097\/00004583-200212000-00016","article-title":"Race differences in the age at diagnosis among medicaid-eligible children with autism","volume":"41","author":"Mandell","year":"2002","journal-title":"J Am Acad Child Adolesc Psychiatry."},{"issue":"6","key":"2026071612513211100_r4","doi-asserted-by":"crossref","first-page":"e1503","DOI":"10.1542\/peds.2007-1680","article-title":"Prevalence of developmental delays and participation in early intervention services for young children","volume":"121","author":"Rosenberg","year":"2008","journal-title":"Pediatrics."},{"issue":"10","key":"2026071612513211100_r5","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1007\/s10995-012-1208-3","article-title":"A family psychosocial risk questionnaire for use in pediatric practice","volume":"17","author":"Pati","year":"2013","journal-title":"Matern Child Health J."},{"issue":"3","key":"2026071612513211100_r6","doi-asserted-by":"crossref","first-page":"417","DOI":"10.3102\/00346543075003417","article-title":"Socio-economic status and achievement: a meta-analytic review of research","volume":"75","author":"Sirin","year":"2005","journal-title":"Rev Educ Res."},{"issue":"4","key":"2026071612513211100_r7","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s13524-014-0301-1","article-title":"How resource dynamics explain accumulating developmental and health disparities for teen parents\u2019 children","volume":"51","author":"Mollborn","year":"2014","journal-title":"Demography."},{"issue":"1","key":"2026071612513211100_r8","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1136\/jech.2009.103291","article-title":"Socioeconomic inequality profiles in physical and developmental health from 0\u20137\u00a0years: Australian National Study","volume":"66","author":"Nicholson","year":"2012","journal-title":"J Epidemiol Community Health."},{"issue":"6","key":"2026071612513211100_r9","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/ppe.12086","article-title":"Household wealth and neurocognitive development disparities among school-aged children in Nepal","volume":"27","author":"Patel","year":"2013","journal-title":"Paediatr Perinat Epidemiol."},{"issue":"4","key":"2026071612513211100_r10","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1542\/peds.113.4.887","article-title":"First experiences with early intervention: a national perspective","volume":"113","author":"Bailey","year":"2004","journal-title":"Pediatrics."},{"issue":"6","key":"2026071612513211100_r11","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1542\/peds.2004-1239","article-title":"Thirty-six-month outcomes for families of children with disabilities participating in early intervention","volume":"116","author":"Bailey","year":"2005","journal-title":"Pediatrics."},{"issue":"3","key":"2026071612513211100_r12","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/001440299806400302","article-title":"Family outcomes in early intervention: a framework for program evaluation and efficacy research","volume":"64","author":"Bailey","year":"1998","journal-title":"Except Child."},{"issue":"2","key":"2026071612513211100_r13","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2105\/AJPH.2005.068569","article-title":"Root shock revisited: perspectives of early head start mothers on community and policy environments and their effects on child health, development, and school readiness","volume":"99","author":"McAllister","year":"2009","journal-title":"Am J Public Health."},{"key":"2026071612513211100_r14","volume-title":"What Do International Tests Really Show About U.S. Student Performance?","author":"Carnoy","year":"2013"},{"issue":"3","key":"2026071612513211100_r15","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1542\/peds.2008-0533","article-title":"Disparities in academic achievement and health: the intersection of child education and health policy","volume":"123","author":"Fiscella","year":"2009","journal-title":"Pediatrics."},{"key":"2026071612513211100_r16","volume-title":"26th Annual (2004) Report to Congress on the Implementation of the Individuals with Disabilities Education Act, Vol 1","author":"Office of Special Education and Rehabilitative Services, Office of Special Education Programs","year":"2005"},{"key":"2026071612513211100_r17","article-title":"US Department of Education","author":"US Department of Education. FY2007 Program performance plan: 2006","year":"2015"},{"issue":"6","key":"2026071612513211100_r18","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.acap.2012.08.006","article-title":"Barriers to evaluation for early intervention services: parent and early intervention employee perspectives","volume":"12","author":"Jimenez","year":"2012","journal-title":"Acad Pediatr."},{"issue":"6","key":"2026071612513211100_r19","doi-asserted-by":"crossref","first-page":"e1141","DOI":"10.1542\/peds.2007-3587","article-title":"\u201cYou get what you get\u201d: unexpected findings about low-income parents\u2019 negative experiences with community resources","volume":"122","author":"Silverstein","year":"2008","journal-title":"Pediatrics."},{"issue":"4","key":"2026071612513211100_r20","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.acap.2014.12.006","article-title":"Understanding barriers to early intervention services for preterm infants: lessons from two states","volume":"15","author":"Little","year":"2015","journal-title":"Acad Pediatr."},{"issue":"1","key":"2026071612513211100_r21","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1037\/1091-7527.26.1.30","article-title":"Partnership for women\u2019s health: a new-age collaborative program for addressing maternal depression in the postpartum period","volume":"26","author":"Baker-Ericz\u00e9n","year":"2008","journal-title":"Fam Syst Health."},{"issue":"12","key":"2026071612513211100_r22","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1002\/pon.2018","article-title":"Cross-cultural validation of a Patient satisfaction with Interpersonal Relationship with Navigator measure: a multi-site patient navigation research study","volume":"21","author":"Pascal","year":"2012","journal-title":"Psychooncology."},{"issue":"12","key":"2026071612513211100_r23","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1002\/cncr.23960","article-title":"National Cancer Institute Patient Navigation Research Program methods, protocol, and measures","volume":"113","author":"Freund","year":"2009","journal-title":"Cancer."},{"issue":"3","key":"2026071612513211100_r24","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1001\/jamapediatrics.2020.5218","article-title":"Effect of family navigation on diagnostic ascertainment among children at risk for autism: a randomized clinical trial from DBPNet","volume":"175","author":"Feinberg","year":"2021","journal-title":"JAMA Pediatr."},{"issue":"5","key":"2026071612513211100_r25","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.acap.2023.03.013","article-title":"Effect of family navigation on participation in Part C early intervention","volume":"23","author":"Feinberg","year":"2023","journal-title":"Acad Pediatr."},{"issue":"3","key":"2026071612513211100_r26","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1037\/fsh0000207","article-title":"Patient navigation to promote early intervention referral completion among poor urban children","volume":"34","author":"Guevara","year":"2016","journal-title":"Fam Syst Health."},{"issue":"4","key":"2026071612513211100_r27","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/j.1475-6773.2010.01119.x","article-title":"Short assessment of health literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers","volume":"45","author":"Lee","year":"2010","journal-title":"Health Serv Res."},{"issue":"4","key":"2026071612513211100_r28","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/(SICI)1099-0917(199612)5:4<271::AID-EDP138>3.0.CO;2-D","article-title":"Assessing the child\u2019s cognitive home environment through parental report: reliability and validity","volume":"5","author":"Dreyer","year":"1996","journal-title":"Early Dev Parent."},{"key":"2026071612513211100_r29","volume-title":"Bayley Scales of Infant and Toddler Development","author":"Bayley","year":"2006","edition":"3rd ed"},{"key":"2026071612513211100_r30","doi-asserted-by":"crossref","DOI":"10.1002\/9781119513469","volume-title":"Applied Longitudinal Analysis","author":"Fitzmaurice","year":"2011","edition":"2nd ed"},{"key":"2026071612513211100_r31","volume-title":"Models for Discrete Longitudinal Data","author":"Molenberghs","year":"2005"},{"key":"2026071612513211100_r32","volume-title":"Cox Proportional Hazards Regression Model. Regression Modeling Strategies","author":"Harrell","year":"2001"},{"issue":"1","key":"2026071612513211100_r33","first-page":"1","article-title":"Impact of the COVID-19 pandemic on early intervention service use among children with developmental disabilities","volume":"3","author":"Kwok","year":"2024","journal-title":"J Pediatr Adv Res."},{"issue":"4","key":"2026071612513211100_r34","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1002\/cncr.21214","article-title":"Using navigators to improve care of underserved patients: current practices and approaches","volume":"104","author":"Dohan","year":"2005","journal-title":"Cancer."},{"issue":"2 Suppl","key":"2026071612513211100_r35","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1002\/cncr.22354","article-title":"Improving follow-up to abnormal breast cancer screening in an urban population. A patient navigation intervention","volume":"109","author":"Battaglia","year":"2007","journal-title":"Cancer."},{"issue":"1","key":"2026071612513211100_r36","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ypmed.2006.08.001","article-title":"Patient navigation and case management following an abnormal mammogram: a randomized clinical trial","volume":"44","author":"Ell","year":"2007","journal-title":"Prev Med."},{"issue":"10","key":"2026071612513211100_r37","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1158\/1055-9965.EPI-12-0523","article-title":"The Ohio Patient Navigation Research Program: does the American Cancer Society patient navigation model improve time to resolution in patients with abnormal screening tests?","volume":"21","author":"Paskett","year":"2012","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"issue":"4","key":"2026071612513211100_r38","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1352\/0895-8017(1998)102<0319:EOEIFV>2.0.CO;2","article-title":"Effectiveness of early intervention for vulnerable children: a developmental perspective","volume":"102","author":"Guralnick","year":"1998","journal-title":"Am J Ment Retard."},{"issue":"5","key":"2026071612513211100_r39","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1542\/peds.80.5.650","article-title":"Early intervention for disabled infants and their families: a quantitative analysis","volume":"80","author":"Shonkoff","year":"1987","journal-title":"Pediatrics."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-070970\/1916733\/pediatrics.2025070970.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-070970\/1916733\/pediatrics.2025070970.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T16:51:42Z","timestamp":1784220702000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/4\/e2025070970\/206777\/Family-Navigation-to-Reduce-Disparities-in-Early"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,3,9]]},"published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-070970","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"article-number":"e2025070970"}}