Volume 12 Issue 5
Development and Initial Outcomes of the Interdisciplinary ‘Early Identification and Intervention for Infants Network’ (Ei3) in Los Angeles
Christiana D. Butera,Amy Yeh,Manoj Biniwale,Edward Bloch,Debi Craddock,Mary Doyle,Sai N. Iyer,Kari S. Kretch,Nora Liu,Christine B. Mirzaian,Barbara Sargent,Priscilla Solano,Margaret Swaine andStacey C. Dusing
1Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA
2Los Angeles General Medical Center, Los Angeles, CA 90033, USA
3Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
4Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
5Los Angeles County Department of Public Health, El Monte, CA 91731, USA
6Los Angeles County California Children’s Services, El Monte, CA 91731, USA
7Department of Pediatrics, University of California Los Angeles, Los Angeles, CA 90095, USA
8Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
9Eastern Los Angeles Regional Center, Alhambra, CA 91803, USA
10North Los Angeles County Regional Center, Chatsworth, CA 91311, USA
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Author to whom correspondence should be addressed.
Abstract
Background/Objectives: The Early Identification and Intervention for Infants (Ei3) Network is an interdisciplinary team dedicated to improving early detection and intervention of cerebral palsy (CP) in California. This paper describes the key (1) awareness-building and (2) capacity-building strategies utilized by the Ei3 Network in the first two years. Methods: Awareness-building methods included interactive conference discussions, resource deliverable creation, and the creation of a framework for dissemination. Capacity-building methods were hosting assessment training, gathering stakeholder feedback, and implementation training. All deliverables were created with a minimum of 3 review and revision cycles. We planned, hosted, and provided scholarships for training, including the Hammersmith Infant Neurological Examination (HINE), Prechtl’s GMA, and an implementation conference. Preliminary descriptive statistics and paired samples t-tests were performed on HINE training surveys. Results: Seven resource deliverables were created and distributed. A professional website, @steps2home.org, was launched. Online channels gained followers (146, Instagram; 198, X; 298, Mailchimp). Providers participated in various trainings: the Sykes Symposium on early detection and intervention (70), HINE (211), GMA Basic or Advanced (46), and Implementation Conference (six facilities from April 2023 to June 2024). HINE training participants reported increased ability to identify CP (p = 0.001), knowledge of (p = 0.004) early detection, ability to implement early detection guidelines (p < 0.001), and confidence in performing the HINE on the post-test (79.87%). Conclusions: The first two years of Ei3 resulted in increased awareness of the early detection guidelines through resources to help providers and families navigate complex care systems and dissemination through online and in-person strategies. We built capacity by training an increased number of providers to identify infants at risk of CP and implement the early detection guidelines. Engagement of stakeholders in focus groups, reviewing documents, and including a parent panel throughout the process increased the value of this work and should support the expansion of the network in the next year.
Keywords: early detection guidelines; cerebral palsy; interdisciplinary team formation; Hammersmith Infant Neurologic Examination; capacity building; workforce training; implementation; stakeholder engagement
