Evaluation of “staying on track”: An early identification,tracking, and referral system

The “Staying on Track” project tracked infants, preschoolers, and their families in Brockville, Ontario, Canada for a period of 3 years. Public health nurses at preassigned intervals provided information and counseling for families and made referrals to other agencies if problems were judged to be beyond the expertise of the “Staying on Track” staff. To assess the effectiveness of the program in improving child development, a cohort design was selected to allow development to be assessed over 5½ years in 3 years. Three cohorts and a comparison group were included in the study. Each cohort received different procedures for identification and tracking. Cohort 1 received at least four home visits, cohort 2 received three clinic visits, and cohort 3 received one clinic visit. Intervention and follow-up from these visits included home visits, phone calls, and referrals for all three cohorts. Comparing cohort 1 to cohort 2 at 18 months, highly significant effects were found; few significant differences were found at 3½ years between cohort 2 and 3 and very few positive effects were found for 5½-year-old children who had been in the tracking system since they were 3½ years of age. The results are discussed and recommendations are made about the implications of the study for service provision. © 1998 Michigan Association for Infant Mental Health