INCREASING MEDICAID CHILD HEALTH SCREENINGS - THE EFFECTIVENESS OF MAILED PAMPHLETS, PHONE CALLS, AND HOME VISITS

Objectives. A randomized controlled trial was conducted to test the ef fectiveness and cost-effectiveness of three outreach interventions to promote well-child screening for children on Medicaid. Methods. In rur al North Carolina, a random sample of 2053 families with children due or overdue for screening was stratified according to the presence of a home phone. Families were randomly assigned to receive a mailed pamph let and letter, a phone call, or a home visit outreach intervention, o r the usual (control) method of informing at Medicaid intake. Results. All interventions produced more screenings than the control method, b ut increases were significant only for families with phones. Among fam ilies with phones, a home visit was the most effective intervention bu t a phone call was the most cost-effective. However, absolute rates of effectiveness were low, and incremental costs per effect were high. C onclusions. Pamphlets, phone calls, and home visits by nurses were min imally effective for increasing well-child screenings. Alternate outre ach methods are needed, especially for families without phones.