Early childhood is a critical period, laying the foundation for future growth and deveopment. This foundational period has an outsized effect, impacting health, well-being and achievement across one's lifespan. The U.S. lacks a cohesive early childhood system to support families with young children ages 0-5. The goal of this randomized controlled trial(RCT) is to test if community-based support via community health workers(CHWs) improves social and health services utilization, and child development. Furthermore, the trial will examine if income support enhances the impact of a CHW integrated system. Participants are English and Spanish speaking families with healthy newborns. This RCT was designed based on family priorities, community capacity and needs in a collective impact model. This trial is anchored at a university based children's hospital and involves many partners: families, county health, county leadership, a leading early childhood non-profit organization, the county's Medicaid managed care organization.
18 and Older
Family plans to reside in San Mateo County
Does not plan to move from the County in the next year
Speaks English and/or Spanish
Will not consent to share data via Epic/Study
Caregiver has significant cognitive impairment
Caregiver under contact isolation
Sibling already enrolled in the Baby Bonus Study
Parallel
Community Health Worker
BehavioralA Community Health Worker will assist participants in navigating the medical system and connecting the participants to community services during the first three years of their child's life.
Community Health Worker + Guaranteed Basic Income
BehavioralA Community Health Worker will assist participants in navigating the medical system and connecting the participants to community services during the first three years of their child's life. Participants will also receive a monthly unconditional cash gift for the first three years of their child's life.
Change in attendance at well-child visits
Dates of visits for primary care in Health Plan of San Mateo (HPSM, the county-based Medicaid Managed Care organization) claims data.
Change in attendance at maternal postpartum follow-up visits
Dates of visits for postpartum checks in HPSM claims data.
Change in pediatric Emergency Department visits
Number of visits to the pediatric Emergency Department as per the HPSM claims data.
Change in referrals to Child Protective Services
Number of referrals to Child Protective Services in San Mateo County Human Services Agency administrative data.
Change in parent depression scale score as measured by Patient Health Questionnaire (PHQ-9)
Research coordinators will administer the PHQ-9 survey to parents to evaluate parent depression level.
Change in diagnoses for mental and behavioral health services for the parent - claims data
Assessed through claims data from HPSM Diagnosis ICD-10 of MH/BH diagnoses and BH utilization by provider type
Change in referrals for mental and behavioral health services for the parent - administrative data Family Health Services (FHS)
Assessed through FHS Administrative Data: Maternal mental health referrals, BHRS Admin Data: Enrollment in BHRS mental health services.
Change in referrals for mental and behavioral health services for the parent - administrative data from Behavioral health and Recovery Services (BHRS)
Assessed through BHRS Admin Data: Enrollment in BHRS mental health services.
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Stanford University
Lead sponsor
Health Plan of San Mateo
Collaborator
The Fidelity Charitable Trust
Collaborator
Silicon Valley Community Foundation
Collaborator
San Mateo County Health
Collaborator
First 5 San Mateo County
Collaborator
The Jackie Speier Foundation
Collaborator
Valhalla Foundation
Collaborator
