Development and Initial Outcomes of the Interdisciplinary 'Early Identification and Intervention for Infants Network' (Ei3) in Los Angeles

J Clin Med. 2024 Dec 6;13(23):7442. doi: 10.3390/jcm13237442.

Abstract

Background/Objectives: The Early Identification and Intervention for Infants (Ei3) Network is an interdisciplinary team dedicated to improving early detection and intervention of cerebral palsy (CP) in California. This paper describes the key (1) awareness-building and (2) capacity-building strategies utilized by the Ei3 Network in the first two years. Methods: Awareness-building methods included interactive conference discussions, resource deliverable creation, and the creation of a framework for dissemination. Capacity-building methods were hosting assessment training, gathering stakeholder feedback, and implementation training. All deliverables were created with a minimum of 3 review and revision cycles. We planned, hosted, and provided scholarships for training, including the Hammersmith Infant Neurological Examination (HINE), Prechtl's GMA, and an implementation conference. Preliminary descriptive statistics and paired samples t-tests were performed on HINE training surveys. Results: Seven resource deliverables were created and distributed. A professional website, @steps2home.org, was launched. Online channels gained followers (146, Instagram; 198, X; 298, Mailchimp). Providers participated in various trainings: the Sykes Symposium on early detection and intervention (70), HINE (211), GMA Basic or Advanced (46), and Implementation Conference (six facilities from April 2023 to June 2024). HINE training participants reported increased ability to identify CP (p = 0.001), knowledge of (p = 0.004) early detection, ability to implement early detection guidelines (p < 0.001), and confidence in performing the HINE on the post-test (79.87%). Conclusions: The first two years of Ei3 resulted in increased awareness of the early detection guidelines through resources to help providers and families navigate complex care systems and dissemination through online and in-person strategies. We built capacity by training an increased number of providers to identify infants at risk of CP and implement the early detection guidelines. Engagement of stakeholders in focus groups, reviewing documents, and including a parent panel throughout the process increased the value of this work and should support the expansion of the network in the next year.

Keywords: Hammersmith Infant Neurologic Examination; capacity building; cerebral palsy; early detection guidelines; implementation; interdisciplinary team formation; stakeholder engagement; workforce training.