Referral rates increased dramatically, with the greatest increase at 12 months. Although patients with pediatrician referrals were likely to qualify for services (96%), physician referrals accounted for only 42% of total referrals, which highlights the need for pediatric developmental screening. The 54% Ages and Stages Questionnaire return rate, although acceptable under study conditions, calls for alternative implementation strategies.

Different data sources were used to examine hypothesized relations among neighborhood-, family-, and individual-level variables, and perceptions of neighborhood collective efficacy. Data were from 1,105 individuals (56% female, 42% African American, and 58% White) nested within 55 neighborhoods and 392 families, analyzed within a multilevel design using a 3-level model. At the neighborhood level, the study examined relations between Census, police, and neighborhood representative indicators. At the family level, the model examined the influence of marital status and family income. At the individual level, gender and age were examined. Results indicated that age at the individual level, marital status at the family level, and poverty and perceived gang activity at the neighborhood level predicted levels of neighborhood collective efficacy. The study illustrated significant variation across neighborhoods and families, and demonstrates the utility of combining different sources of neighborhood data to examine relations of interest within a multilevel framework.

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