Screening for lead poisoning in children receiving Medicaid is federally mandated at ages 12 and 24 months, yet only about one-third of Ohio’s eligible children at this age are screened. Using the Access to Care model as a guiding framework, this study compared parental/caregiver self-report of blood lead testing with blood lead testing evidence in Medicaid claims data or in blood lead surveillance data. Data from parents/caregivers were collected via a mailed survey of a random sample of 1,372 parents; blood lead testing data were validated with Ohio Medicaid claims and lead surveillance databases. Survey respondents (n=542) were primarily white (76%), female (97%), with at least a high school education (79%). Fifty-six percent (n=296) reported their child had a blood lead level (BLL) drawn; 16% did not know. A blood lead testing could be not confirmed with claims/surveillance data for 44% (n=140) of these children. For 23% (n=54) of those reporting their child had not been tested, claims/surveillance data indicated blood lead testing had been completed. Logistic regression revealed the odds of a blood lead test per claims/surveillance data was 3.1 (CI=1.9,4.9) times greater if the child had a well-child visit in the previous three years; 1.8 (CI=1.2,2.7) times greater if they were an urban dweller, 1.8 (CI=1.2,2.7) times greater if the parent reported receiving a reminder to have their child tested, 1.6 (CI=1.1,2.4) times greater if the child was over 2 years old; and 1.6 (CI=1.1, 2.5) times greater if the parent reported receiving lead poisoning prevention information. Results suggest parents may not be aware if their child had actually been tested for blood lead. Nurses need to provide written documentation to parents regarding blood lead testing, assure reminders are sent to parents, and provide lead poisoning prevention education to all parents of young children.
Session #1186 - Occupational & Community Health
The 29th Annual MNRS Research Conference (April 1-4, 2005)