Increasing Medicaid child health screenings: the effectiveness of mailed pamphlets, phone calls, and home visits

Am J Public Health. 1995 Oct;85(10):1412-7. doi: 10.2105/ajph.85.10.1412.


Objectives: A randomized controlled trial was conducted to test the effectiveness and cost effectiveness of three outreach interventions to promote well-child screening for children on Medicaid.

Methods: In rural 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 pamphlet and letter, a phone call, or a home visit outreach intervention, or the usual (control) method of informing at Medicaid intake.

Results: All interventions produced more screenings than the control method, but increases were significant only for families with phones. Among families with phones, a home visit was the most effective intervention but a phone call was the most cost-effective. However, absolute rates of effectiveness were low, and incremental costs per effect were high.

Conclusions: Pamphlets, phone calls, and home visits by nurses were minimally effective for increasing well-child screenings. Alternate outreach methods are needed, especially for families without phones.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Child
  • Child Health Services / economics
  • Child Health Services / statistics & numerical data*
  • Community-Institutional Relations*
  • Cost-Benefit Analysis
  • Female
  • Health Promotion / economics
  • Health Promotion / methods*
  • Home Care Services
  • Humans
  • Male
  • Mass Screening / economics
  • Mass Screening / statistics & numerical data*
  • Medicaid / statistics & numerical data*
  • North Carolina
  • Pamphlets
  • Rural Health
  • Telephone
  • United States