WHAT'S KNOWN ON THIS SUBJECT: Young children have multiple upper respiratory infections (URI) annually. Limited health literacy regarding URI can place families at risk for emergency department (ED) visits, inappropriate use of over-the-counter medications, and medication measurement errors.WHAT THIS STUDY ADDS: Few educational interventions for URI have targeted groups with limited health literacy. Integrating an educational intervention into Early Head Start is a novel approach to increasing parental health literacy regarding URI and decreasing ED visits, with potential for wide dissemination. abstract OBJECTIVES: To evaluate the effectiveness of an educational intervention to decrease pediatric emergency department (PED) visits and adverse care practices for upper respiratory infections (URI) among predominantly Latino Early Head Start (EHS) families.METHODS: Four EHS sites in New York City were randomized. Families at intervention sites received 3 1.5-hour education modules in their EHS parent-child group focusing on URIs, over-the-counter medications, and medication management. Standard curriculum families received the standard EHS curriculum, which did not include URI education. During weekly telephone calls for 5 months, families reported URI in family members, care sought, and medications given. Pre-and post-intervention knowledge-attitude surveys were also conducted. Outcomes were compared between groups.RESULTS: There were 154 families who participated (76 intervention, 78 standard curriculum) including 197 children ,4 years old. Families were primarily Latino and Spanish-speaking. Intervention families were significantly less likely to visit the PED when their young child (age 6 to ,48 months) was ill (8.2% vs 15.7%; P = .025). The difference remained significant on the family level (P = .03). These families were also less likely to use an inappropriate over-the-counter medication for their ,2-year-old child (odds ratio, 0.29; 95% confidence interval, 0.09-0.95; 12.2% vs 32.4%, P = .034) and/or incorrect dosing tool for their ,4-yearold child (odds ratio, 0.24; 95% confidence interval, 0.08-0.74; 9.8% vs 31.1%; P , .01). The mean difference in Knowledge-Attitude scores for intervention families was higher. Dr Stockwell conceptualized and designed the study, took part in the analysis of the data, and drafted the initial manuscript; Drs Catallozzi, Larson, Rodriguez, Subramony, and Meyer aided in the conceptualization and design of the study and reviewed and revised the manuscript; Dr Andres Martinez carried out the initial analyses and critically reviewed the manuscript; Ms Martinez helped in the design of the educational material, coordinated the teaching aspect of the intervention, and critically reviewed the manuscript; Ms Barrett helped design the data collection instruments, coordinated and supervised data collection at all sites, and critically reviewed the manuscript; and all authors approved the final manuscript as submitted. 19 and regarding URIs specifically. 7,[20][21][22] They are also at ...