Program For Low-income Children Research Articles

Effectiveness of an Enrichment Program for Young Children Enrolled in Head Start Programs

ABSTRACT The Developmental Screening, Monitoring, and Enrichment (DSME) program for low-income children and families is an initiative developed to support the goal of the Healthy People 2020 and 2030 that aims to increase the number of healthy young children to be ready for school. The 8-week DSME program focuses on reducing health disparities and improving the health of low-income children. A quasi-experimental research study was conducted to examine the effectiveness of the DSME program in 43 children enrolled in three Head Start programs. The children received weekly enrichment activities for 8 weeks. Each child was administered with Denver Developmental Screening Test-II at three intervals (week 1, week 4, and week 8) to identify their developmental levels and monitor their progress in four areas including personal-social, fine-motor, language, and gross-motor. Additionally, the parents received two 1-hour educational trainings to learn about children’s developmental milestones and strategies used to monitor and address their children’s developmental concerns. The data were analyzed using repeated measures ANOVA and paired t-test. The DSME program was found to be effective and can be easily implemented to any Head Start programs. The DSME program can help to increase the proportion of young children who are ready for school.

Addressing Childhood Hunger during the Summer Months: Using Gleaned Produce for Snacks and Interactive Nutrition Education on Food Systems and Healthy Eating

ABSTRACT In the United States, 6.5 million children experience food insecurity. The purpose of this project was to evaluate the Building Blocks for Healthy Kids summer nutrition education program for low-income children. Twenty-six children ages 6–11 years participated in the six-lesson program that included snacks incorporating gleaned produce. Plate waste data indicated 55-80% of the served snack was consumed. Knowledge related to nutrition and food systems increased between pre- and post-intervention (p < .0001). At post-intervention, children reported practicing more mindful and sustainable eating practices. Overall, the program increased knowledge and improved food-related behaviors in low-income children.

Inside the classroom door: Understanding early care and education workforce and classroom characteristics experienced by children in subsidized center-based care

The federal child care subsidy program is the nation’s largest public early care and education (ECE) program for low-income children, yet little research has documented the workforce and classroom characteristics that affect children’s experiences in subsidized classrooms. Moreover, no existing study has compared the workforce and classroom characteristics in subsidized classrooms to those in classrooms across the range of alternative center-based settings available to low-income children. To fill this knowledge gap, the present study uses data from the newest national survey of child care available – the National Survey of Early Care and Education (NSECE), collected in 2012 – to describe subsidized classrooms on a broad set of workforce and classroom characteristics. Classrooms serving children with child care subsidies are compared to other classrooms serving low-income children, with a distinction between those that receive other public funds (Head Start or school-based pre-k), and those that do not (non-publicly-funded centers). Consistent with prior research, which finds classrooms serving subsidized children to have lower observed global quality than Head Start or pre-k classrooms, our findings reveal that classrooms serving children receiving subsidies typically have a more disadvantaged workforce and fewer classroom characteristics indicative of higher quality and believed to promote child development. Compared to non-publicly-funded center-based classrooms, classrooms serving subsidized children scored lower on several desirable workforce characteristics such as hourly pay and receipt of coaching, but did not differ on classroom characteristics.

Outpatient Care Preceding Hospitalization for Diabetic Ketoacidosis.

To identify patterns of outpatient care associated with diabetic ketoacidosis (DKA) among pediatric patients with type 1 diabetes (T1D). Retrospective cohort study using Medicaid claims data from 2009 to 2012 for children with T1D enrolled ≥365 consecutive days in California Children's Services, a Title V program for low-income children with chronic disease. Outcome was DKA hospitalization >30 days after enrollment. Outpatient visits to primary care, endocrinology, pharmacies, and emergency departments (EDs) were assessed during the 6 months before an index date: either date of first DKA hospitalization or end of enrollment for those without DKA. Univariate and multivariate analysis was used to evaluate independent associations between DKA and outpatient care at clinically meaningful intervals preceding the index date. Among 5263 children with T1D, 16.7% experienced DKA during the study period. Patients with DKA were more likely to have had an ED visit (adjusted odds ratio [aOR] 3.99, 95% confidence interval [CI]: 2.60-6.13) or a nonpreventive primary care visit (aOR 1.35, 95% CI: 1.01-1.79) within 14 days before the index date, and less likely to have visited an endocrinologist (aOR 0.76, 95% CI: 0.65-0.89) within the preceding 120 days. Preventive visits and pharmacy claims were not associated with DKA. For children with T1D, recent ED visits and long intervals without subspecialty care are important signals of impending DKA. Combined with other known risk factors, these health-use indicators could be used to inform clinical and case management interventions that aim to prevent DKA hospitalizations.

Limited Exposure: Children’s Activities and Neighborhood Effects in the Gautreaux Two Housing Mobility Program

ABSTRACT:Housing mobility programs intend to improve the well-being of low-income families by changing the neighborhood environment in which they live, and thereby creating access to a new set of opportunities and resources. Using data collected in a study of the Gautreaux Two (G2) Housing Mobility program, which offered housing vouchers to public housing residents in Chicago to move to lower-poverty and less segregated “opportunity” neighborhoods, this article explores families’ access to programs and services for their children in the neighborhoods where they move. The analysis is based on a sample of 46 families who moved through the G2 program. Qualitative in-depth interviews were conducted with mothers in four waves, which started when the family still lived in public housing. The results show that almost three-quarters of the families utilized activities for their children in the baseline neighborhoods, but mothers also expressed concerns about the safety and lack of program variety available in these disadvantaged neighborhoods. After moving through the G2 program, only one-third of the children in these families are using activities. The decline in activity participation is especially steep for children in families that move to areas outside of the city. Although few mothers are concerned with safety or the variety of programs available, several report barriers to activities for children in the new neighborhood, including fewer programs for low-income children, high cost, transportation difficulties, and issues finding daycare or preschool for younger children. Some children continue to use activities in the old neighborhood and some families end up making subsequent moves to nonqualifying neighborhoods. These findings suggest that activity participation is important for many low-income families, and losing access to these activities upon moving through the G2 program may limit children’s exposure to the new neighborhood and contribute to subsequent moves.

A Study of Health Care Coverage Among Children in Immigrant Families in the Post Welfare-Reform Era

ABSTRACT The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) has targeted lawful immigrants by imposing a broad range of restrictions on access to federally funded benefit programs. Within the federal restrictions, however, states have been granted considerable latitude concerning immigrants. In Temporary Assistance for Needy Families (TANF) and Medicaid, the major benefit programs for low-income children, states are authorized to determine whether these programs are to be provided to immigrant families. First, this study examines variations in immigrant provisions across states in Medicaid, TANF, and state health care programs. Second, the study estimates the impact of state immigrant provisions in those programs on the uninsured among children of immigrants. Using the 1999 Current Population Survey (CPS), the study finds that state-funded Medicaid and state health care programs made available to ineligible immigrants (under PRWORA) significantly decrease the risk of being uninsured for children of immigrants, while controlling all other socio-economic-geographical variables. A child's citizenship is also found to be a significant and strong predictor for being uninsured among children of immigrants.

A Food Bank Collaborates with Federal Food Assistance Programs to Reduce Child Hunger

ABSTRACT Although the U.S. Department of Agriculture offers a summer feeding program for low-income children, less than one-quarter of eligible children participate. Another federal child nutrition program, the Child and Adult Care Food Program (CACFP), provides funding for snacks and meals served to after-school programs. The purpose of this paper is to describe how a local food bank became involved with these programs and grew statewide participation from 40,000 to 128,000 children in a 4-year period in the summer feeding program and more than doubled the number of meals served in CACFP. The use of the organization's community training kitchen is explained and the role of volunteers is highlighted in keeping program costs to a minimum. We hope that showcasing our successful experience with the Summer Food Service Program will encourage other food service operations to consider undertaking this worthwhile effort to help meet the nutritional needs of low-income children.

Book Review of Making Play Work: The Promise of After-School Programs for Low-Income Children.

Book Review of Making Play Work: The Promise of After-School Programs for Low-Income Children.

Emotional Competence and Early School Adjustment: A Study of Preschoolers at Risk

This short-term longitudinal study examined whether emotion regulation and emotion understanding made unique contributions towards at-risk preschoolers' classroom adaptation. To address this question, we assessed children's emotion regulation and their understanding of emotions in both self (self-awareness, emotion coping) and in others (emotion recognition, affective perspective taking, situation knowledge). Participants were 49 children (22 boys and 27 girls) who attended a Head Start program for low-income children. Seventy percent of this sample was Caucasian, with the remainder being of Latino, African American or biracial ethnicity. Emotion regulation at the start of the school year was associated with school adjustment at year's end, whereas early emotional lability/negativity predicted poorer outcomes. Children who made a smooth adjustment to preschool also were better able to take another person's affective perspective and to identify situations that would provoke different emotional responses. Emotion regulation and understanding made unique contributions towards school adjustment, even when controlling for potential confounds, including behavior problems and verbal abilities. Teachers appeared to influence children's emotional competence by serving an important regulatory function, especially for older preschoolers at-risk.

Evaluation of a state health insurance program for low-income children: implications for state child health insurance programs.

The State Child Health Insurance Program (SCHIP) is the largest public investment in child health care in 30 years, targeting 11 million uninsured children, yet little is known about the impact of health insurance on uninsured children. In 1991, New York State implemented Child Health Plus (CHPlus), a health insurance program that became a model for SCHIP: To examine changes in access to care, utilization of services, and quality of care among children enrolled in CHPlus. A pre-post design was used to evaluate the health care experiences of children in the year before enrollment in CHPlus and during the year after CHPlus enrollment. New York State, stratified into 4 regions: New York City, urban counties around New York City, upstate urban counties, and upstate rural counties. A total of 2126 children (0-12.99 years of age) who enrolled in CHPlus in 1992-1993. Parents were interviewed by telephone, and primary care medical charts were reviewed for 694 children (0-3. 99 years of age). Access, utilization, and quality of care measures for each child were compared for the year before and the year after CHPlus enrollment, controlling for age, geographic region, previous insurance coverage, and CHPlus plan type (indemnity or managed care). Enrollment in CHPlus was associated with fewer children lacking a medical home (5% before CHPlus vs 1% during CHPlus), with the greatest change occurring in New York City (11% vs 1%), where access before CHPlus was lowest. CHPlus was also associated with increased primary care visits: by 25% for preventive visits, by 52% for acute visits, and by 42% for total visits. The number of specialists seen during CHPlus was more than twice as high than before CHPlus. CHPlus was not associated with changes in emergency department utilization, although hospitalizations, which were not covered by CHPlus, were 36% lower during CHPlus coverage. Use of public health departments for immunizations declined by 64%, with more immunizations delivered in the medical home during CHPlus coverage. One third of parents reported improved quality of health care for their child as a result of CHPlus, and virtually none noted worse quality of care. This statewide health insurance program for low-income children was associated with improved access, utilization, and quality of care, suggesting that SCHIP has the potential to improve health care for low-income American children.

Federalism and the Safety Net: Delinkage and Participation Rates

Since the enactment of welfare reform legislation in 1996, the federal government and the states have emphasized putting the needy to work and reducing caseloads. Simultaneously, however national policymakers delinked eligibility for cash assistance from eligibility for other safety-net benefits. Contrary to stated policy, though, this delinkage has led to declining participation in the case of Food Stamps and health-insurance programs for low-income children. We highlight four factors that states must shape if they are to narrow this gap between policy promise and program performance byfostering higherparticipation. We show how ourfocus intersects with enduring questions of American federalism-the level of state commitment to redistributive programs, their capacity to implement these programs effectively, and the degree to which states can augment governing capacity by becoming more genuine laboratories of democracy.

Lead screening among low-income children in Galveston, Texas.

The objective of this study was to report results of a lead-screening program for low-income children living in Galveston, Texas. We obtained blood lead by graphite furnace spectrophotometry on 1,571 children aged 6 months to 8 years. Nineteen percent of children had blood lead levels > or = 10 mcg/dL. Risk factors included African-American ethnicity, young age, and residence in old housing. Follow-up was accomplished in only 50% of children with low-level toxicity. Lead screening is an important public health measure in communities with old houses. For screening to be successful, caregivers need to devote additional effort to follow-up.

Kiwis and kids, communities and connections: The lessons of energy express on bridging policy and community discourse

Intervention programs for low-income children and families must work to connect the policies and practices of intervention to the communities that they intend to serve. This article describes Energy Express, a summer reading and nutrition program for children in low-income communities across the state of West Virginia. Energy Express has consistently demonstrated beneficial effects in maintaining and improving children's reading and in increasing collaboration between schools and other community organizations. The success of the program in each community is attributed in part to the ways in which the program acknowledges and values local knowledge, the purposeful tension between centralization of planning and purpose and localization in implementation, and the understanding of the multiple meanings of community. © 1999 John Wiley & Sons, Inc.

Bicycle helmet promotion among low income preschool children

Objective—To evaluate the effectiveness of a multifaceted bicycle helmet promotion program for low income children attending preschool enrichment programs throughout Washington State. Study sample—Preschool Head Start programs that conducted routine...