Addressing Barriers to Accessing Head Start Programs via the Medical Home: A Qualitative Study

Objectives High quality early childhood education and childcare programs, such as Early Head Start and Head Start (EHS/HS), play a critical role in early childhood development, learning, and quality of life. This study was designed to determine barriers to applying and enrolling in EHS/HS in an urban community and the potential role of the medical home in overcoming these barriers. Methods Four 90-minute focus groups were conducted with 41 various stakeholders, including EHS/HS coordinators, personnel from early childhood policy organizations, medical personnel, and families who have previously applied to EHS/HS. Participants were recruited from an academic clinic and early childhood organizations in Chicago. Researchers transcribed the focus groups and independently analyzed data using open and focused coding to identify common themes. Results Results demonstrate that medical personnel and families have a limited understanding of EHS/HS as a resource. Participants describe a multitude of difficulties navigating the EHS/HS application, misalignment of requirements and poor communication between EHS/HS programs and the medical home. Conclusions for Practice: Multiple barriers exist for families enrolling children into EHS/HS. We recommend several interventions based in the medical home that may improve the enrollment process, allowing more eligible families to access high-quality early childhood services, such as EHS/HS. Significance Quality early childhood education, and particularly Early Head Start and Head Start, has many known long-term benefits for children. Despite awareness of these benefits in the pediatric and early childhood education communities, many eligible children are not enrolled in Early Head Start and Head Start programs. This study investigates barriers in the medical home that may prevent children from enrolling into Early Head Start and Head Start, and how they might be addressed. Streamlined communication between the medical home and Early Head Start and Head Start programs may facilitate more children accessing this important educational resource.