Model-Driven Research: Increasing Use of Health Services for Indigent Children

A theoretical framework can provide coherence and direction to an ongoing series of research activities conducted in a variety of settings by collaborative investigators. An adaptation of the PRECEDE health education model provides the theoretical framework for research activities conducted by The Healthy Kids Project, a cooperative effort in North Carolina that investigates cost-effective interventions that increase use of the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). The EPSDT provides comprehensive preventive health services for indigent children from birth to age 21, and the Healthy Kids Project focuses on interventions that nurses can use to increase EPSDT use. In the PRECEDE model, interventions must consider predisposing, reinforcing, and enabling factors that contribute to the behavioral causes of the identified problem. The adapted PRECEDE model has assisted The Healthy Kids Project research activities by: (1) guiding selection of research priorities; (2) helping integrate contributions from diverse collaborators; (3) guiding design and evaluation of research interventions; and (4) helping interpret, synthesize, and disseminate research findings. In addition, the model provides stability to the project focus as participants change over time. A diagram of the adapted PRECEDE model is included. (MM)