1	High Intensity Targeted Screening (HITS)
2	Elimination of Childhood Lead Poisoning Goal: To eliminate childhood lead poisoning as a public health problem in the US by 2010
3	Goals of HITS Primary Goals: Determine prevalence Evaluate screening Evaluate elmination progress Capture other child health data Secondary Goals: Identify children missed by routine screening Develop partnerships Increase awareness
4	Background
5	Chicago Childhood Lead Poisoning Prevention Program
6
7	Sampling Method for Prevalence Study Cluster survey design Population proportional to estimated size sampling Random selection of clusters & starting address (source: 2000 Census & Chicago Building Footprint GIS Data) Sample size calcs. based on HHs, prevalence 80% power, 5% margin of error, 20% intra-class correlation Visitation rules
8
9	Methods: Enrollment of Children Eligibility Children aged 1-5 years, live at address at least 30 hours per week, parent/guardian provides informed consent, did not matter about previous blood lead testing status Incentives To improve participation rates
10	Components of a visit Notate outcome in door to door log Informed Consent Draw Venous Blood Child questionnaire for each child Household questionnaire for each home Immunization records documentation Incentive provided ($15 grocery coupon)
11	Staff & Time Most intensive efforts on Saturdays and Sundays for 2 or 3 weekends 15 teams of 2 or 3 – community based worker, PHA (Interviewer), and phlebotomist Follow-up visits during the week (2 or 3 teams) HHs with 1 child = 15 minutes
12	"Vacant = 9.7" Vacant = 9.7% Refused=5.4% Not Eligible=60.0% Other=9.4% Enrolled=15.5%
13
14	After the field work… All survey and BLL data is data-entered in Access DB Result letters sent 1-2 months later CDPH is follows-up with children with BLLs > 10 mg/dL Report findings to communities
15	Limitations HITS is a prevalence study – not intended to be substitute for regular blood lead screening programs Maintaining scientific rigor difficult when faced with realities of field work Finding the correct time of year (spring is better than fall, summer is unpleasant) Time and resource intensive Refusals can be problematic, especially in some communities
16	Successes Identification of new children Media exposure Better direction of resources Leverage for funding Coincides with CDPH’s mission Model that can be adapted
17	HITS Partners CDPH (Chicago Department of Public Health) Westside Health Authority (Community Agency) Lawndale Christian Health Center CDC (Centers for Disease Control and Prevention) EPA (U.S. Environmental Protection Agency) IDPH (Illinois Department of Public Health) CMS (Centers for Medicare and Medicaid Services) HUD (U.S. Department of Housing and Urban Development) WIC (Special Nutrition Program for Women, Infants, and Children)
18	Thanks for your time! I’ll be happy to take any questions! (Also feel free to call or e-mail with questions or comments: MacRoy_Patrick@cdph.org 312-746-5007)