| Over the past 30 years, one of the bigger public health problems has been getting young children screened for lead. The group most in peril of not being screened is children (newborn-24 months) who are enrolled in a Medicaid health plan. The purpose of this study was to: (a) assess the screening rates of Medicaid-enrolled children living in Michigan, Minnesota, and North Carolina; and (b) investigate whether screening rates have improved among the different counties in Michigan, Minnesota, and North Carolina. Using the theoretical foundations of the diffusion of innovations theory, the research questions attempted to determine any positive increases in blood lead screening resulting from the National Committee for Quality Assurance (NCQA) requirement of mandatory reporting of lead screening results. This study used a quasi-experimental design with secondary data collected from Michigan, Minnesota, and North Carolina Departments of Public Health and the NCQA from 2006 to 2009. Kruskal-Wallis test and Wilcoxon paired sample tests showed a general increase in blood lead screening among all states in all years except for Michigan during 2007. Results suggest that this screening requirement is a partial success as a public health intervention. These findings of this dissertation will be used to help improve service delivery. Before the results of this study, there was no evidence suggesting the new policy made a difference in screening rates. However, the results of this study show that mandated screening helped to increase screening rates. These findings are especially salient in areas known to have high prevalence of childhood lead poisoning but low screening rates as these results can now be used to provide evidence for the importance of mandated testing of children living in high risk areas. |
