An Evaluation of Nurse Health Navigator Utilization within Healthy Beginnings System of Care in Atlanta, Georgia Pubblico
Pylant, Sarah (Spring 2018)
Abstract
Introduction: Healthy Beginnings System of Care program is located within Educare Sheltering Arms in Atlanta, Georgia and uses a Nurse Health Navigator (NHN) to provide health resources and education to children within this early learning center. To determine the program’s impact, it is necessary to assess what participants are using the NHN and why they seek aid. This thesis aims to examine commonalities among the high utilizers of the NHN from 2011 to 2017. Further, this thesis will assess NHN utilization to obtain how many high utilizers were in each school year and for how many years a child was a high utilizer.
Methods: Healthy Beginnings’ data was collecting on an ongoing basis by Healthy Beginning’s staff members. Data is stored in a REDCap database, which contained the 648 observations used in this analysis. The NHN Visit Form tracked NHN visits and produced a count of number of visits per year for each child. A dichotomous variable was created from this count to distinguish high utilizers from regular utilizers. Logistic regression analyses were performed to assess the impact of child’s chronic condition status on NHN utilization, controlling for other health and demographic factors.
Results: Healthy Beginnings participants with chronic conditions were more likely to be high utilizers of the NHN than children without any chronic conditions (aOR=2.29, 95% CI: (1.49, 3.52), p<0.001). Specifically, children with asthma or other respiratory conditions were expected to be high utilizers (aOR=3.06, 95% CI: (1.42, 6.61), p-value=0.0044). Child’s parent’s education status and insurance type tested significant for their effect on a child’s NHN utilization status. Other variables used in this analysis were not significant on impacting NHN utilization.
Discussion: Children with chronic conditions, especially those with respiratory conditions, are more likely to seek aid from the NHN indicating these should be the children targeted in these programs. Children whose parents have earned at least a graduate degree were also likely to use the NHN more frequently than other enrolled children. Finally, insurance type impacted the relationship of interest indicating this variable should be used in future analyses of systems of care within early learning facilities.
Table of Contents
Table of Contents
I. Introduction…………………………………………….……… 1
A. Health care delivery systems—overview…………. 1
B. Health disparities in children in the united states…. 2
C. School based health centers……………….………. 4
D. Federal head start programs……………………...... 7
E. Healthy beginnings system of care……………….... 8
F. Project aims…......………………………………….... 10
II. Methods……………………………………………………….... 11
A. Program setting….………………………………...….. 11
B. Program population………………………………..….. 11
C. Eligibility……………...……………………………..... 12
E. Data measures………….…………………………..….. 12
F. Data analysis……………………………….……..…..... 15
III. Results……………...………………………………………....... 17
IV. Discussion…………………………………………………......... 19
A. Strengths and limitations…………………………….... 22
B. Implications………………………………………….... 23
C. Conclusion………………………………………...…... 24
V. References………………………………………………....…...... 26
VI. Tables and figures…………………………………………........ 29
VII. Appendices…………………………………………….……..... 38
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