Evaluation of the stability of cervical specimens collected by swab and stored dry for human papillomavirus DNA testing

evidence base of how these covariates influence child cognition and to illustrate the benefits of early education programs in low-resource settings. The aim of this study is to evaluate the association between the federally funded education program Early Head Start (EHS) and the cognitive abilities of children in low-income family enrollees and assess if this association varies by the quality of the home environment and the existence of maternal depression. We hypothesize that the EHS program has a positive direct effect on infant cognition, and that maternal depression and a diminished home environment will modify this association, leading to reduced scores in infant cognition. Methods: A large-scale impact evaluation of the EHS program for low-income pregnant women and families with children up to 3 years of age, this prospective study followed a diverse racial/ethnic group of 3,001 children from 17 sites, both urban and rural, from 1996 to 2010. The analysis examines infants from enrollment to age 3. Eligible families were randomly assigned to control or program groups with equal probabilities, with requirements including having a focus child less than 12 months of age at enrollment. Control groups were unable to receive program services until focus child was at least 3 years old. Data was collected using self-enumerated questionnaires, personal interviews, and direct observation. Statistical analyses included independent t-tests, linear regression, and testing for confounding, mediation, and interaction. Cognitive performance, the primary outcome, was measured by the Bayley Scale (2nd Ed.) Findings: Of 2977 total subjects, 1503 subjects were randomly assigned into the program group. Independent t-tests indicated that exposure to EHS services had a significant effect on cognitive performance at 24 months (p1⁄4.0155) and 36 months (p1⁄4.0698). Linear regression analyses indicated that home environment and program status had interaction effects (p1⁄4.0376) at 36 months but not 24 months. Maternal depression did not have interaction effects. Interpretation: Results support the main hypothesis that cognitive performance follows a trend of being higher in children receiving EHS services. Home and environment and maternal depression had small or null effects on this association. This could be due to study design or inappropriate selection and use of assessment tools. Results inspire further research and suggest that EHS interventions may override the effect of these risk factors. Funding: No funding was used for this analysis. Abstract #: 02NCD014