Table 3.
The Health Care Components of ABC for the Treated Children
| Component | Content |
|---|---|
| Well-Child Care | |
| Well-Child Visits | Assessments were made at 2, 4, 6, 9, 12, 18,
and 24 months, and yearly thereafter. A health history and a social history were obtained and a complete physical examination was performed. |
| Immunizations | Appropriate immunizations (diphteria, pertussis, tetanus, polio, measles, mumps, and rubella) as recommended by the American Academy of Pediatrics were given. |
| Lab Tests | A sickle cell preparation was obtained at 9
and 12 months from all black children. A skin test for tubercolosis was given yearly, and a hematocrit was done at 9 and 18 months and yearly thereafter. During symptom-free periods, the children were cultured for bacteria at two-week intervals, and for viruses and mycoplasmas every four weeks. |
| Health Education | The parents were present at the child
well-care visits. They were taught and counseled in the areas of:
feeding and nutrition, weaning, cleanliness, skin care, child growth and
development, behavior, toilet training, accident prevention, and dental
hygiene. They were also encouraged to express their concerns and to discuss the problems that they were facing. |
| Vision Hearing | Routine screening for vision was provided
annually. During symptom-free periods, the children underwent pneumatic otoscopy and tympanometry once a month. If any tympanogram was abnormal, the child was seen for repeat otoscopy and tympanometry after two weeks. |
| Ill-Child Care (for Treated Children Only after the First Year) | |
| Sick-care | Daily surveillance of all children in the
center for illness: the licensed practical nurse visited the classroom
daily to review the health status of the children and receive reports
from the parents. Children who were unwell were promptly seen by a member of the health care staff. A history was obtained and a physical examination done; appropriate laboratory tests and cultures were performed. Children had their upper respiratory secretions cultured by throat swab and a saline nasal wash for isolation of viruses and bacteria. A computer form was completed each time the child was examined, listing pertinent history, physical findings, diagnosis, and culture results. Parents were informed of the nature of the child’s ailment, and given prescriptions, but were responsible for buying medicines. The family nurse practitioner made sure that half of the prescriptions were sent home and half to the center. The children were followed through the illness to recovery. They were allowed to attend the center when ill except in case of chickenpox. These referrals were made to specialists and hospitals but specialized visits and hospitalizations were not paid for. |
Notes: Sources: Campbell (2014); Ramey et al. (1982); Sanyal et al. (1980).
*
In the first year of the study, the control children received medical care from the FPG center. After the first year, they were left on their own.
Free medical care for the control children was offered by FPGC and 2 university-affiliated hospitals to control families, and reports suggest that this incentive was discontinued after the first year (Heckman et al., 2014a; Ramey et al., 1976).