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Fierloos IN, Windhorst DA, Fang Y, Bannink R, Stam M, Slijkerman CAA, Jansen W, Raat H. A prospective study on the association between social support perceived by parents of children aged 1-7 years and the use of community youth health care services. Front Public Health 2022; 10:950752. [PMID: 36249185 PMCID: PMC9561893 DOI: 10.3389/fpubh.2022.950752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Aim This study examined the association between social support perceived by parents of children aged 1-7 years and the use of additional community youth health care services. Methods Data of 749 parents of children aged 1-7 years, gathered in the CIKEO cohort study in the Netherlands, were analyzed. Social support was assessed with the Multidimensional Scale of Perceived Social Support. Data on the use of additional community youth health care services during a period of 1.5 years were obtained from the electronic records of participating youth health care organizations. Multivariable logistic regression models were used to examine the association between perceived social support and the use of additional youth health care services and to explore moderation by the parent's educational level. Results The mean age of the responding parents was 33.9 years (SD = 5.1); 93.6% were mothers. Parents who perceived low to moderate levels of social support had 1.72 (95% CI: 1.11, 2.66) times higher odds of using one or more additional youth health care services during the study period compared to parents who perceived high levels of social support at baseline. This association was independent of predisposing factors, but not independent of need factors (p > 0.05). Furthermore, the association was moderated by the educational level of the parent (p = 0.015). Among parents with a high educational level, low to moderate levels of perceived social support at baseline were associated with 2.93 (95% CI: 1.47, 5.83) times higher odds of using one or more additional youth health care services during the study period independent of predisposing and need factors. Among parents with a low or middle educational level the association between perceived social support and use of additional youth health care services was not significant. Conclusion Our findings provide evidence that low to moderate levels of perceived social support are associated with a higher use of additional community youth health care services among parents of children aged 1-7 years, especially among high educated parents. Recommendations for policy and practice are provided.
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Affiliation(s)
- Irene N. Fierloos
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Dafna A. Windhorst
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands,TNO Child Health, Leiden, Netherlands
| | - Yuan Fang
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | | | | | - Wilma Jansen
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands,Department of Social Development, City of Rotterdam, Rotterdam, Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands,*Correspondence: Hein Raat
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Novel instrument to guide nurse-led consultations with parents of three-year-olds in school health services in Flanders: A feasibility study of SPARK36. J Pediatr Nurs 2022; 64:e145-e153. [PMID: 34949519 DOI: 10.1016/j.pedn.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/25/2021] [Accepted: 12/01/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND In the framework of new legislation on School Health Services (SHS) in Flanders (Belgium), nurses lead a preventive consultation with every three-year-old child and its parent(s), with the aim of assessing risks in child development and potential parenting problems. This study assesses the feasibility of the "Structured Problem Analysis of Raising kids aged 36 months" (SPARK36), a broad-scope structured interview to facilitate such consultations. DESIGN AND METHODS A feasibility study was conducted with SHS nurses across Flanders, to determine need for this instrument, acceptability and practical feasibility of SPARK36 with both parents and professionals. Nurses were trained to use the instrument. Mixed methods (i.e., questionnaires for both parents and nurses, and a focus group interview with nurses) were used to evaluate the feasibility of using SPARK36. RESULTS Parents were satisfied (97.0%) with what was discussed during the consultation and with the consultation's structure (98.8%). After the training, all 20 nurses felt strengthened in performing the consultation and in making a risk assessment. The interview was feasible in 20-30 min. During 561 interviews nurses gave parenting support in 88.2% of cases. CONCLUSIONS SPARK36 is acceptable, practically feasible for parents and nurses, and it meets needs of both parties. The instrument supports nurses during their consultation. More research is needed to evaluate the instrument and to prepare its implementation in daily practice. PRACTICE IMPLICATIONS SPARK36 is a promising instrument for nurse-led consultations in the SHS setting.
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Kanits F, L'Hoir MP, Boere-Boonekamp MM, Engelberts AC, Feskens EJM. Renewed Attention Needed for Prevention of Sudden Unexpected Death in Infancy in the Netherlands. Front Pediatr 2021; 9:757530. [PMID: 34938696 PMCID: PMC8685403 DOI: 10.3389/fped.2021.757530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/09/2021] [Indexed: 01/14/2023] Open
Abstract
Background: The incidence of sudden unexpected death in infancy (SUDI), which includes sudden infant death syndrome (SIDS), has declined in developed countries since the 1980s, including the Netherlands. To identify improvement opportunities in SUDI prevention, we monitored the adherence of parents to the prevention advice on infant care habits over the past 20 years, especially in relation to the SUDI incidence over time. Potential changes in parental adherence between the latest surveys are of specific interest, as these indicate where current focus is needed. Methods: Description of the prevalence of infant care factors related to the risk of SUDI, assessed from five Dutch national surveys from 1999 to 2017 among parents of infants under 12 months, and analysis of the potential differences in these prevalences between the two latest surveys in 2010/11 and 2017 with a z-test. Results: Supine sleeping position decreased from the highest prevalence of 92% in 2010/11, to 83% in 2017. Sleep sack use has increased to 55%, the highest prevalence up to now. Avoiding a duvet has remained reasonably stable since 2002/03 and now 95% of parents do not use a duvet. The prevalence of room-sharing, without sharing the bed, increased from 14% in 1999 to the highest prevalence in 2017 (31%). However, also bed-sharing almost doubled from 5.6% in 2010/11 to 10% in 2017. Breastfeeding decreased between 1999 and 2010/11, but increased from 34% in 2010/11 to 42% in 2017. An increased prevalence of mothers who abstained from smoking during pregnancy, as well as both parents not smoking, was observed, although mostly higher educated parents showed this beneficial behavior. Discussion and Conclusion: Much has already been achieved first by decreasing prone sleeping since the 80's, and subsequently promoting supine as the safest sleep position. The decrease in duvet use and smoking, and an increase in breastfeeding have also had impact. Indications of a recent decreased prevalence of the supine sleeping position and higher prevalence of bed-sharing might relate to the slightly increasing SUDI incidence in the Netherlands. Renewed attention for prevention of SUDI and specific advice targeting high-risk groups is needed. Modern, picture driven information via internet is recommended.
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Affiliation(s)
- Floortje Kanits
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Monique P. L'Hoir
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Community Health Centre, GGD Noord-Oost-Gelderland, Warnsveld, Netherlands
| | - Magda M. Boere-Boonekamp
- Department of Health Technology and Services Research, University of Twente, Enschede, Netherlands
| | - Adèle C. Engelberts
- Department of Pediatrics, Zuyderland Medical Centre, Sittard-Geleen, Netherlands
| | - Edith J. M. Feskens
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
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Kanits F, L'Hoir MP, Boere-Boonekamp MM, Engelberts AC, Feskens EJM. Risk and Preventive Factors for SUDI: Need We Adjust the Current Prevention Advice in a Low-Incidence Country. Front Pediatr 2021; 9:758048. [PMID: 34869115 PMCID: PMC8635138 DOI: 10.3389/fped.2021.758048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The incidence of Sudden Unexpected Death in Infancy (SUDI) is low in the Netherlands, with an incidence rate of 0.18 per 1,000 live births. Therefore, prevention advice may receive less attention, potentially leading to increasing incidence rates. It is currently unknown whether the risks for SUDI changed in the Netherlands, and if other risk factors might be present. The aim of this study was to examine the current risks and preventive factors for SUDI in Dutch infants, in order to determine if it is necessary to adapt the prevention advice toward the current needs. Methods: A case-control study was conducted comparing SUDI cases aged <12 months from 2014-2020 in the Netherlands (n = 47), to a Dutch national survey control group from 2017 including infants <12 months of age (n = 1,192). Results: Elevated risks for several well-known factors were observed, namely: duvet use (aOR = 8.6), mother smoked during pregnancy (aOR = 9.7), or after pregnancy (aOR = 5.4) and the prone sleeping position (aOR = 4.6). Reduced risks were observed for the well-known factors: room-sharing (aOR = 0.3), sleep sack use (aOR = 0.3), breastfeeding (aOR = 0.3), and the use of a pacifier (aOR = 0.4). For infants <4 months, the risk for SUDI was higher when bed-sharing (aOR = 3.3), and lower when room-sharing (aOR = 0.2) compared to older infants. For older infants, the sleep sack was found to be more protective (aOR = 0.2). A high risk for SUDI when bed-sharing was found when mother smoked, smoked during pregnancy, or if the infant did not receive any breastfeeding (respectively aOR = 17.7, aOR = 10.8, aOR = 9.2). Conclusions: Internationally known factors related to the sudden unexpected death of infants were also found in this study. Relatively new findings are related to specific groups of infants, in which the strengths of these risk factors differed. In a low-incidence country like the Netherlands, renewed attention to the current prevention advice is needed. Furthermore, additional attention for prevention measures in low educated groups, and additional advice specifically targeting high-risk groups is recommended.
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Affiliation(s)
- Floortje Kanits
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Monique P. L'Hoir
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Community Health Center, GGD Noord-Oost-Gelderland, Warnsveld, Netherlands
| | - Magda M. Boere-Boonekamp
- Department of Health Technology & Services Research, University of Twente, Enschede, Netherlands
| | - Adèle C. Engelberts
- Department of Pediatrics, Zuyderland Medical Center, Sittard-Geleen, Netherlands
| | - Edith J. M. Feskens
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
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Koning NR, Büchner FL, van den Berg AW, Choi SYA, Leeuwenburgh NA, Paijmans IJM, van Dijk-van Dijk DJA, Numans ME, Crone MR. The Usefulness of Electronic Health Records From Preventive Youth Healthcare in the Recognition of Child Mental Health Problems. Front Public Health 2021; 9:658240. [PMID: 34136452 PMCID: PMC8202822 DOI: 10.3389/fpubh.2021.658240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives: Early identification of child mental health problems (MHPs) is important to provide adequate, timely treatment. Dutch preventive youth healthcare monitors all aspects of a child's healthy development. We explored the usefulness of their electronic health records (EHRs) in scientific research and aimed to develop prediction models for child MHPs. Methods: Population-based cohort study with anonymously extracted electronic healthcare data from preventive youth healthcare centers in the Leiden area, the Netherlands, from the period 2005–2015. Data was analyzed with respect to its continuity, percentage of cases and completeness. Logistic regression analyses were conducted to develop prediction models for the risk of a first recorded concern for MHPs in the next scheduled visit at age 3/4, 5/6, 10/11, and 13/14 years. Results: We included 26,492 children. The continuity of the data was low and the number of concerns for MHPs varied greatly. A large number of determinants had missing data for over 80% of the children. The discriminatory performance of the prediction models were poor. Conclusions: This is the first study exploring the usefulness of EHRs from Dutch preventive youth healthcare in research, especially in predicting child MHPs. We found the usefulness of the data to be limited and the performance of the developed prediction models was poor. When data quality can be improved, e.g., by facilitating accurate recording, or by data enrichment from other available sources, the analysis of EHRs might be helpful for better identification of child MHPs.
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Affiliation(s)
- Nynke R Koning
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Frederike L Büchner
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Anouk W van den Berg
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - S Y Angelique Choi
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | | | | | | | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Mathilde R Crone
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
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van den Toren SJ, van Grieken A, Raat H. Associations of socio-demographic characteristics, well-being, school absenteeism, and substance use with recreational nitrous oxide use among adolescents: A cross-sectional study. PLoS One 2021; 16:e0247230. [PMID: 33600449 PMCID: PMC7891713 DOI: 10.1371/journal.pone.0247230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE A rapid increase of recreational nitrous oxide use (i.e. laughing gas, N2O) has been reported in several countries, while it has received limited attention in scientific research. We aimed to study the association of socio-demographic characteristics, mental well-being, sickness absence, truancy, and substance use with the frequency of lifetime nitrous oxide use among adolescents. METHODS We used self-reported questionnaire data of adolescents (N = 555) attending secondary schools to cross-sectionally assess the frequency of nitrous oxide use and potential factors associated with nitrous oxide use, such as gender, mental well-being, and binge drinking. Ordinal logistic regression models were applied with lifetime nitrous oxide use (never, once, ≥ two times) as the outcome variable. RESULTS Adolescents were on average 15.6 years old (SD = 0.83, range 14-18), 47.0% were female. In total, 86 (15.6%) adolescents had used nitrous oxide at least once in their life. In the multivariable ordinal regression model, the risk of having a higher category of lifetime nitrous oxide use was associated with a non-Dutch ethnic background (OR = 2.10, 95% CI 1.22; 3.61), attending pre-vocational education (OR = 1.88, 95% CI 1.06; 3.34), a higher score on the scale of externalizing problems (OR = 1.10, 95% CI 1.01; 1.20), binge drinking twice or more in the past four weeks (OR = 2.49, 95% CI 1.25; 4.94), and cannabis use (OR = 1.98, 95% CI 1.03; 3.79). CONCLUSIONS Youth Health Care professionals should be aware of nitrous oxide use in adolescents, especially among adolescents with a non-Dutch ethnic background, lower education levels, externalizing problems, frequent binge drinking, and cannabis use.
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Affiliation(s)
| | - Amy van Grieken
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
- * E-mail:
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Laserna Jiménez C, López Poyato M, Casado Montañés I, Guix-Comellas EM, Fabrellas N. Paediatric nursing clinical competences in primary healthcare: A systematic review. J Adv Nurs 2021; 77:2662-2679. [PMID: 33594748 DOI: 10.1111/jan.14768] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/22/2020] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Abstract
AIMS To identify and critically appraise the available evidence on paediatric nurses' clinical competencies performed autonomously regarding disease prevention and health promotion activities for children and adolescents in primary healthcare worldwide. DESIGN A systematic review design in accordance with the Preferred Reporting Items Systematic Reviews and Meta-Analyses statement. DATA SOURCES The search was conducted through MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, SCOPUS, The Cochrane Library, Scientific Electronic Library Online, Web of Science and The Joanna Briggs Institute EBP (Ovid) databases. The grey literature was reviewed at OpenGrey. Additional studies were located through a references list of selected studies identified on first search. REVIEW METHODS Database search employed MeSH terms: (paediatric nursing) AND (primary healthcare) AND ((clinical skills) OR (clinical competences)). Studies published from inception to October 2019 exploring paediatric nurses' clinical competencies in primary healthcare were eligible for inclusion. No language restrictions were applied in the main search. Selection was made by two reviewers independently. Three independent reviewers assessed the methodological quality of included studies. RESULTS Eighteen studies were included from six countries. The most common nursing competencies independently performed identified and described in studies were Health education and advice, Child and adolescent health and development assessment, Immunizations and Child health checks. CONCLUSION Studies describe clinical competencies of nurses in children care. No consistent scientific evidence is available about clinical competencies of paediatric nurses performed autonomously in primary care. IMPACT Few scientific studies identifying and assessing nurses' child primary healthcare skills were found and therefore recorded. Studies describe nurses' clinical skills in childhood, but results do not show firm consistency assessing their practice scope. Health policy-makers should encourage the development of nurses' competencies if they wish to preserve quality and equity of healthcare services to children. Therefore, the first step is to identify the autonomous competencies of paediatric nurses in primary care.
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Affiliation(s)
- Cristina Laserna Jiménez
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mireia López Poyato
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Health Centre Les Corts, Consorci d'Atenció Primària de Salut de Barcelona Esquerra de l'Eixample (CAPSBE), Barcelona, Spain
| | | | - Eva Maria Guix-Comellas
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Núria Fabrellas
- School of Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Quantitative and temporal approach to utilising electronic medical records from general practices in mental health prediction. Comput Biol Med 2020; 125:103973. [DOI: 10.1016/j.compbiomed.2020.103973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 01/06/2023]
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Adolescents' Views on Seeking Help for Emotional and Behavioral Problems: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010191. [PMID: 31892118 PMCID: PMC6981849 DOI: 10.3390/ijerph17010191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022]
Abstract
This study aimed to get insight into adolescents’ views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends.
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Sijpkens MK, Lagendijk J, van Minde MRC, de Kroon MLA, Bertens LCM, Rosman AN, Steegers EAP. Integrating interconception care in preventive child health care services: The Healthy Pregnancy 4 All program. PLoS One 2019; 14:e0224427. [PMID: 31693703 PMCID: PMC6834275 DOI: 10.1371/journal.pone.0224427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022] Open
Abstract
Background Most parents with young children pay routine visits to Well-Baby Clinics, or so-called Preventive Child Health Care (PCHC) services. This offers a unique opportunity to promote and deliver interconception care. This study aimed to integrate such care and perform an implementation evaluation. Methods In seven Dutch municipalities, PCHC professionals were instructed to discuss the possibility of an interconception care consultation during each routine six-months well-baby visit. The primary outcome of this study was coverage of the intervention, quantified as the proportion of visits during which women were informed about interconception care. Secondary outcomes included adoption, fidelity, feasibility, appropriateness, acceptability and effectiveness of the intervention, studied by surveying PCHC professionals and women considering becoming pregnant. Results The possibility of interconception care was discussed during 29% (n = 1,849) of all visits, and 60% of the PCHC physicians adopted the promotion of interconception care by regularly informing women. About half of the PCHC professionals and most women judged integration of interconception care in PCHC appropriate and acceptable. Estimated feasibility was poor, since 13% of the professionals judged future integration in daily practice as probable. The uptake of interconception care consultations was low (n = 4 consultations). Conclusions Promotion of interconception care was achieved in approximately one-third of the routine PCHC consultations and appeared promising with regards to adoption, appropriateness and acceptability. However, concerns on feasibility and uptake of interconception care consultations in daily practice remain. Suggestions for improvement may include further integration of interconception care health promotion in routine PCHC consultations, while allocating sufficient resources.
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Affiliation(s)
- Meertien K. Sijpkens
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Jacqueline Lagendijk
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Minke R. C. van Minde
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marlou L. A. de Kroon
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Loes C. M. Bertens
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ageeth N. Rosman
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Health Care Studies, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Eric A. P. Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Koning NR, Büchner FL, Vermeiren RR, Crone MR, Numans ME. Identification of children at risk for mental health problems in primary care-Development of a prediction model with routine health care data. EClinicalMedicine 2019; 15:89-97. [PMID: 31709418 PMCID: PMC6833364 DOI: 10.1016/j.eclinm.2019.09.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite being common and having long lasting effects, mental health problems in children are often under-recognised and under-treated. Improving early identification is important in order to provide adequate, timely treatment. We aimed to develop prediction models for the one-year risk of a first recorded mental health problem in children attending primary care. METHODS We carried out a population-based cohort study based on readily available routine healthcare data anonymously extracted from electronic medical records of 76 general practice centers in the Leiden area, the Netherlands. We included all patients aged 1-19 years on 31 December 2016 without prior mental health problems. Multilevel logistic regression analyses were used to predict the one-year risk of a first recorded mental health problem. Potential predictors were characteristics related to the child, family and healthcare use. Model performance was assessed by examining measures of discrimination and calibration. FINDINGS Data from 70,000 children were available. A mental health problem was recorded in 27•7% of patients during the period 2007-2017. Age independent predictors were somatic complaints, more than two GP visits in the previous year, one or more laboratory test and one or more referral/contact with other healthcare professional in the previous year. Other predictors and their effects differed between age groups. Model performance was moderate (c-statistic 0.62-0.63), while model calibration was good. INTERPRETATION This study is a first promising step towards developing prediction models for identifying children at risk of a first mental health problem to support primary care practice by using routine healthcare data. Data enrichment from other available sources regarding e.g. school performance and family history could improve model performance. Further research is needed to externally validate our models and to establish whether we are able to improve under-recognition of mental health problems.
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Affiliation(s)
- Nynke R. Koning
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600 Postzone V0-P/V6-68, 2300 RC Leiden, The Netherlands
| | - Frederike L. Büchner
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600 Postzone V0-P/V6-68, 2300 RC Leiden, The Netherlands
| | - Robert R.J.M. Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Curium-LUMC, The Netherlands
- VU University Medical Center, Amsterdam, The Netherlands
| | - Mathilde R. Crone
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600 Postzone V0-P/V6-68, 2300 RC Leiden, The Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, PO Box 9600 Postzone V0-P/V6-68, 2300 RC Leiden, The Netherlands
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Konijnendijk AAJ, Boere-Boonekamp MM, Haasnoot ME, Need A. Effects of a computerised guideline support tool on child healthcare professionals' response to suspicions of child abuse and neglect: a community-based intervention trial. BMC Med Inform Decis Mak 2019; 19:161. [PMID: 31416453 PMCID: PMC6694693 DOI: 10.1186/s12911-019-0884-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 07/29/2019] [Indexed: 01/22/2023] Open
Abstract
Background Healthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the seven recommended guideline activities, and on time spent seeking information presented in this guideline. Methods A community-based intervention trial design was applied, comparing access to a paper-based guideline (control) with access to a paper-based guideline supplemented with a computerised guideline support tool (intervention). A total of 168 child healthcare doctors and nurses working in one large Dutch organisation were allocated to an intervention or control group. Outcomes were professionals’ performance of seven recommended guideline activities and the amount of time spent seeking information presented in the guideline. Professionals’ adherence was measured using two methods: health record analysis and a self-report questionnaire. The questionnaire was also used to collect data on the amount of time spent seeking guideline information. Results In total, 152 health records (102 in the intervention group and 50 in the control group) were available for analysis. The tool was registered in 14% of the records in the intervention group. Performance of activities, corrected for intentional non-adherence, was except for one activity, high (range 80–100%); no differences were found between the control and intervention groups. Forty-nine questionnaires (24 in the intervention group and 25 in the control group) were analysed. Sixty-three percent of the questionnaire respondents (15/24) claimed to have used the tool. No differences in guideline adherence were found between the two groups. Respondents in the intervention and control groups spent, on average, 115 and 153 min respectively seeking relevant information presented in the guideline. Conclusions The results regarding use of the tool were inconclusive as the outcomes differed per method. In contrast to expectations, performance of guideline activities was high in both groups. The support tool may decrease the amount of time spent on seeking guideline information. However, given the high adherence scores and small number of questionnaire respondents, the outcomes failed to reach statistical significance. Future research should focus on studying the effects of the tool after a longer period of availability. Electronic supplementary material The online version of this article (10.1186/s12911-019-0884-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annemieke A J Konijnendijk
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Institute for Innovation and Governance Studies, P.O. Box 217, 7500 BK, Enschede, the Netherlands.
| | - Magda M Boere-Boonekamp
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Institute for Innovation and Governance Studies, P.O. Box 217, 7500 BK, Enschede, the Netherlands
| | - Maria E Haasnoot
- Municipal Health Service GGD Twente, Department of Preventive Child Healthcare, P.O. Box 1400, 7500 BK, Enschede, the Netherlands
| | - Ariana Need
- Department of Public Administration, Institute for Innovation and Governance Studies, University of Twente, P.O. Box 217, 7500 BK, Enschede, the Netherlands
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13
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Koning NR, Büchner FL, Verbiest MEA, Vermeiren RRJM, Numans ME, Crone MR. Factors associated with the identification of child mental health problems in primary care-a systematic review. Eur J Gen Pract 2019; 25:116-127. [PMID: 31246106 PMCID: PMC6713156 DOI: 10.1080/13814788.2019.1623199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Although common and often with long-lasting effects, child mental health problems (MHPs) are still under-recognized and under-treated. A better understanding of the factors associated with the identification of MHPs in primary care may improve the recognition of MHPs. Objectives: To review studies on factors associated with the identification of child MHPs in primary care. Methods: Six leading databases were systematically searched until 1 October 2018. Two independent researchers selected articles and extracted data on study characteristics and factors associated with MHP identification. Inclusion criteria were the investigation of factors associated with MHP identification by primary care professionals (PCPs) in children aged 0–18 years. Results: Of the 6215 articles identified, 26 were included. Prevalence rates of PCP-identified MHPs varied between 7 and 30%. PCPs identified 26–60% of children with an increased risk of MHPs as indicated by MHP assessment tools, but associated factors were investigated in relatively few studies. MHPs were more often identified in children with a family composition other than married parents, with worse mental health symptoms, prior MHPs, among boys in elementary school, when contact with PCPs was related to parental psychosocial concerns or routine health check-ups, when PCPs were recently trained in MHPs or when PCPs felt less burdened treating MHPs. Conclusion: MHP identification varied substantially between studies and PCPs and was related to several child, family and practice factors. Future studies should systematically investigate factors associated with MHP identification by PCPs and specifically in children with an increased risk of MHPs according to mental health assessment tools.
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Affiliation(s)
- Nynke R Koning
- a Department of Public Health and Primary Care, Leiden University Medical Centre , Leiden , The Netherlands
| | - Frederike L Büchner
- a Department of Public Health and Primary Care, Leiden University Medical Centre , Leiden , The Netherlands
| | - Marjolein E A Verbiest
- b Centre for Longitudinal Research-He Ara ki Mua, The University of Auckland , Auckland , New Zealand.,c National Institute for Health Innovation, The University of Auckland , Auckland , New Zealand
| | - Robert R J M Vermeiren
- d Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Curium-LUMC , Oegstgeest , The Netherlands.,e Department of Child and Adolescent Psychiatry Amsterdam, UMC location VU , Amsterdam , The Netherlands
| | - Mattijs E Numans
- a Department of Public Health and Primary Care, Leiden University Medical Centre , Leiden , The Netherlands
| | - Mathilde R Crone
- a Department of Public Health and Primary Care, Leiden University Medical Centre , Leiden , The Netherlands
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Guérin C, Van Hoeck K, Denys S, Van Wieringen A, Wouters J, Hoppenbrouwers K. Systematische opsporing van lawaaischade bij jongeren. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s12452-018-0153-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Korndewal MJ, Oudesluys-Murphy AM, Kroes ACM, van der Sande MAB, de Melker HE, Vossen ACTM. Long-term impairment attributable to congenital cytomegalovirus infection: a retrospective cohort study. Dev Med Child Neurol 2017; 59:1261-1268. [PMID: 28990181 DOI: 10.1111/dmcn.13556] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 01/09/2023]
Abstract
AIM This study aimed to estimate long-term impairment attributable to congenital cytomegalovirus infection (cCMV). METHOD This nationwide cohort study retrospectively assessed cCMV in children born in 2008 in the Netherlands, testing 31 484 stored neonatal dried blood spots. Extensive medical data of cCMV-positive children (n=133) and matched cCMV-negative comparison children (n=274) up to 6 years of age were analysed. RESULTS Moderate to severe long-term impairment was diagnosed in 24.8% (33 out of 133) of all cCMV-positive children (53.8% in symptomatic, 17.8% in asymptomatic), compared with 12.0% (33 out of 274) of cCMV-negative children. Sensorineural hearing loss was seen only in five cCMV-positive children (3.8%). Developmental delays were diagnosed more often in cCMV-positive children than cCMV-negative children: motor (12.0% vs 1.5%), cognitive (6.0% vs 1.1%), and speech-language (16.5% vs 7.3%). Long-term impairment in multiple domains was more frequent in symptomatic (19.2%) and asymptomatic (8.4%) cCMV-positive children than cCMV-negative children (1.8%). INTERPRETATION Children with cCMV were twice as likely to have long-term impairment up to the age of 6 years, especially developmental delays and sensorineural hearing loss, than cCMV-negative comparison children, with a risk difference of 12.8%. These insights into the risk of cCMV-associated impairment can help optimize care and stimulate preventive measures. WHAT THIS PAPER ADDS Congenital cytomegalovirus infection (cCMV) leads to impairment in 25% of cases. Fifty per cent of children with cCMV symptoms at birth have long-term impairment. The risk difference of moderate to severe long-term impairment between children with and without cCMV is 13%, attributable to cCMV. cCMV leads to motor, cognitive, and speech-language developmental delay in children.
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Affiliation(s)
- Marjolein J Korndewal
- Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Aloys C M Kroes
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marianne A B van der Sande
- Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hester E de Melker
- Center for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ann C T M Vossen
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands
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Bezem J, Kocken PL, Kamphuis M, Theunissen MHC, Buitendijk SE, Numans ME. Triage in preventive child healthcare: a prospective cohort study of care use and referral rates for children at risk. BMJ Open 2017; 7:e016423. [PMID: 29084789 PMCID: PMC5665215 DOI: 10.1136/bmjopen-2017-016423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES A novel triage approach to routine assessments was introduced to improve the efficiency of Preventive Child Healthcare (PCH): PCH assistants carried out pre-assessments of all children and sent the children with suspected health problems to follow-up assessments conducted by a physician or nurse. This two-step approach differed from the usual approach, in which physicians or nurses assessed all children. This study was aimed to examine the impact of triage and task shifting on care for children at risk identified by PCH or parents and schools. DESIGN AND PARTICIPANTS An observational prospective cohort design was used, with an analysis of the basic registration data from the preventive health assessments for 1897 children aged 5 to 6, and 10 to 11, years from a sample of 41 schools stratified by socioeconomic status, region of PCH service and urbanisation. SETTING A comparison was made between two PCH services in the Netherlands that used the triage approach and two PCH services that provided the usual approach. MAIN OUTCOME MEASURES The primary outcome measures were the referral rates to either additional PCH assessments or external services. The secondary outcome measures were the rates of PCH assessments requested by, for example, parents and schools. RESULTS Overall, a higher referral rate to additional PCH assessments was found for the triage approach than for the usual approach (OR 1.3, 95% CI 1.0 to 1.6), mainly in the age group of 5 to 6 years (OR 1.9, 95% CI 1.3 to 2.7). We found a lower rate of referral to external services in the triage approach (OR 0.4, 95% CI 0.3 to 0.7) and a higher referral rate to PCH assessments on request (OR=4.6, 95% CI 3.0 to 7.0). CONCLUSIONS The triage approach provides extra opportunities to deliver PCH assessments and PCH assessments on request for children at risk. Further research is needed into the cost benefits of the triage approach.
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Affiliation(s)
- Janine Bezem
- Preventive Child Health Care Department, Gelderland-Midden Municipal Health Service, Arnhem, The Netherlands
- Department of Child Health, TNO, Leiden, The Netherlands
| | - Paul L Kocken
- Department of Child Health, TNO, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mascha Kamphuis
- Zuid Holland West Municipal Health Service, Zoetermeer, The Netherlands
| | | | | | - Mattijs E Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
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17
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Ascione F, Cascone D, Napolitano F, Di Giuseppe G. Evaluation of the use of health care services for non-communicable disease and prevention by children and adolescents in south Italy. BMC Health Serv Res 2017; 17:532. [PMID: 28778162 PMCID: PMC5545043 DOI: 10.1186/s12913-017-2489-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 08/01/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The objectives of this investigation are to evaluate the use of health care services for non-communicable disease and prevention by children and adolescents and to identify the factors linked to the use of health care services. METHODS This cross-sectional survey was conducted between December 2014 and January 2015 among 1198 parents of students aged between 5 and 18 years attending 12 selected schools in the geographic area of Salerno and Naples, Italy, using a self-administered questionnarie. RESULTS 68.2% of parents stated that had visited their general practitioner (GP) or family pediatrician (FP) with their child in the last year. 66.2% of children had had at least one visit to a specialist and more than half (54.8%) had had preventive care visits in the last year. The use of preventive care visits within last year was significantly higher amongst female, among those who had visited their GP or FP and among those who had a parent with a college degree or higher. The proportion of emergency department visits and hospital admissions reported were 12.8% and 4.7% respectively. CONCLUSION This results highlights the need of educational interventions for parents and adolescents in order to increase the utilization of preventive health services.
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Affiliation(s)
- Flora Ascione
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Via Luciano Armanni, 5, 80138 Naples, Italy
| | - Diana Cascone
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Via Luciano Armanni, 5, 80138 Naples, Italy
| | - Francesco Napolitano
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Via Luciano Armanni, 5, 80138 Naples, Italy
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Via Luciano Armanni, 5, 80138 Naples, Italy
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18
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Waelput AJM, Sijpkens MK, Lagendijk J, van Minde MRC, Raat H, Ernst-Smelt HE, de Kroon MLA, Rosman AN, Been JV, Bertens LCM, Steegers EAP. Geographical differences in perinatal health and child welfare in the Netherlands: rationale for the healthy pregnancy 4 all-2 program. BMC Pregnancy Childbirth 2017; 17:254. [PMID: 28764640 PMCID: PMC5540512 DOI: 10.1186/s12884-017-1425-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 07/18/2017] [Indexed: 03/01/2023] Open
Abstract
Background Geographical inequalities in perinatal health and child welfare require attention. To improve the identification, and care, of mothers and young children at risk of adverse health outcomes, the HP4All-2 program was developed. The program consists of three studies, focusing on creating a continuum for risk selection and tailored care pathways from preconception and antenatal care towards 1) postpartum care, 2) early childhood care, as well as 3) interconception care. The program has been implemented in ten municipalities in the Netherlands, aiming to target communities with a relatively disadvantageous position with regard to perinatal and child health outcomes. To delineate the position of the ten participating municipalities, we present municipal and regional differences in the prevalence of perinatal mortality, perinatal morbidity, children living in deprived neighbourhoods, and children living in families on welfare. Methods Data on all singleton births in the Netherlands between 2009 and 2014 were analysed for the prevalence of perinatal mortality and morbidity. In addition, national data on children living in deprived neighbourhoods and children living in families on welfare between 2009 and 2012 were analysed. The prevalence of these outcomes were calculated and ranked for 62 geographical areas, the 50 largest municipalities and the 12 provinces, to determine the position of the municipalities that participate in HP4All-2. Results Considerable geographical differences were present for all four outcomes. The municipalities that participate in HP4All-2 are among the 25 municipalities with the highest prevalence of perinatal mortality, perinatal morbidity, children living in deprived neighbourhoods, or children in families on welfare. Conclusion This study illustrates geographical differences in perinatal health and/or child welfare outcomes and demonstrates that the HP4All-2 program targets municipalities with a relative unfavourable position. By targeting these municipalities, the program is expected to contribute most to improving the care for young children and their mothers at risk, and hence to reducing their risks and health inequalities. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1425-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adja J M Waelput
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Meertien K Sijpkens
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Jacqueline Lagendijk
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Minke R C van Minde
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands.,Department of Public Health, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Hiske E Ernst-Smelt
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Marlou L A de Kroon
- Department of Public Health, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Ageeth N Rosman
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Jasper V Been
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands.,Department of Paediatrics, Division of Neonatology, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Loes C M Bertens
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre Rotterdam, Postbus 2040, 3000 CA, Rotterdam, the Netherlands
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19
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Konijnendijk AAJ, Boere-Boonekamp MM, Kaya AH, Haasnoot ME, Need A. In-house consultation to support professionals' responses to child abuse and neglect: Determinants of professionals' use and the association with guideline adherence. CHILD ABUSE & NEGLECT 2017; 69:242-251. [PMID: 28486161 DOI: 10.1016/j.chiabu.2017.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 06/07/2023]
Abstract
This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals' performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study's inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p=.001), who were more familiar with consultation (p=.002), who had more positive attitudes and beliefs about consultation (p=.011) and who reported being more susceptible to the behavior (p=.001) and expectations/opinions (p=.025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals' responses to CAN are discussed.
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Affiliation(s)
- Annemieke A J Konijnendijk
- Departments of Health Technology and Services Research, and Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands.
| | - Magda M Boere-Boonekamp
- Department of Health Technology and Services Research, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands
| | - Anna H Kaya
- Department of Health Technology and Services Research, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands
| | - Maria E Haasnoot
- Department of Preventive Child Health Care, Municipal Health Service GGD Twente, Enschede, The Netherlands
| | - Ariana Need
- Department of Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands
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20
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Gillison F, Cumming S, Standage M, Barnaby C, Katzmarzyk P. Assessing the impact of adjusting for maturity in weight status classification in a cross-sectional sample of UK children. BMJ Open 2017; 7:e015769. [PMID: 28652292 PMCID: PMC5541588 DOI: 10.1136/bmjopen-2016-015769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To compare the weight categorisation of a cohort of UK children using standard procedures (ie, comparing body mass index (BMI) centiles to age-matched UK reference data) versus an approach adjusted for maturation status (ie, matching relative to biological age). DESIGN Analysis of data collected from an observational study of UK primary school children. SETTING Schools in South West England. PARTICIPANTS Four hundred and seven 9-11 year-old children (98% white British). MAIN OUTCOME MEASURES Weight status was classified using BMI centiles using (1) sex and chronological age-matched referents and (2) sex and biological age-matched referents (based on % of predicted adult stature) relative to UK 1990 reference growth charts. For both approaches, children were classified as a normal weight if >2nd centile and <85thcentile, overweight if 85th and <95thcentiles, and obese if ≥95thcentile. RESULTS Fifty-one children (12.5%) were overweight, and a further 51 obese (12.5%) according to standard chronological age-matched classifications. Adjustment for maturity resulted in 32% of overweight girls, and 15% of overweight boys being reclassified as a normal weight, and 11% and 8% of obese girls and boys, respectively, being reclassified as overweight. Early maturing children were 4.9 times more likely to be reclassified from overweight to normal weight than 'on-time' maturers (OR 95% CI 1.3 to 19). CONCLUSIONS Incorporating assessments of maturational status into weight classification resulted in significant changes to the classification of early-maturing adolescents. Further research exploring the implications for objective health risk and well-being is needed.
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Affiliation(s)
- Fiona Gillison
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Sean Cumming
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Martyn Standage
- Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK
| | - Catherine Barnaby
- Bath Institute for Mathematical Innovation, University of Bath, Bath, UK
| | - Peter Katzmarzyk
- Pennington Biomedical Research Centre, Baton Rouge, Louisiana, USA
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21
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Affiliation(s)
- Oskar G Jenni
- Child Development Center and the Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
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22
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Gillison FB, Lorenc AB, Sleddens EFC, Williams SL, Atkinson L. Can it be harmful for parents to talk to their child about their weight? A meta-analysis. Prev Med 2016; 93:135-146. [PMID: 27746340 DOI: 10.1016/j.ypmed.2016.10.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/26/2016] [Accepted: 10/13/2016] [Indexed: 12/21/2022]
Abstract
Many parents express concern that raising the issue of weight risks harming their child's physical self-perceptions and wellbeing. Such concerns can deter families from engaging with weight management services. This systematic review aimed to investigate the evidence behind these concerns by analysing the association between parent-child weight-talk and child wellbeing. A systematic search of eight databases identified four intervention studies and 38 associative studies. Meta-analysis was only possible for the associative studies; to facilitate more meaningful comparisons, weight-talk was categorized into four communication types and effect size estimates for the association between these and wellbeing indicators were calculated through a random effects model. Encouraging children to lose weight and criticizing weight were associated with poorer physical self-perceptions and greater dieting and dysfunctional eating (effect sizes: 0.20 to 0.47). Conversely, parental encouragement of healthy lifestyles without explicit reference to weight was associated with better wellbeing, but this was only measured in two studies. Of the four intervention studies, only one isolated the effects of parents' communication on wellbeing outcomes, reporting a positive effect. There was no effect of age on the strength of associations, but dysfunctional eating was more strongly associated with parent communication for girls than boys. The findings indicate that some forms of parent-child weight-talk are associated with poor wellbeing, but suggest that this is not inevitable. Encouraging healthy behaviours without reference to weight-control, and positive parental involvement in acknowledging and addressing weight-concern may avoid such outcomes. More longitudinal research is needed to analyse the direction of these effects.
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Affiliation(s)
| | | | - Ester F C Sleddens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stefanie L Williams
- Centre for Technology Enabled Health Research, Coventry University, Coventry, UK
| | - Lou Atkinson
- Centre for Research in Applied Biological and Exercise Sciences, Coventry University, Coventry, UK
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Sijpkens MK, Steegers EAP, Rosman AN. Facilitators and Barriers for Successful Implementation of Interconception Care in Preventive Child Health Care Services in the Netherlands. Matern Child Health J 2016; 20:117-124. [PMID: 27385150 PMCID: PMC5118383 DOI: 10.1007/s10995-016-2046-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives Successful implementation of preconception and interconception care contributes to optimizing pregnancy outcomes. While interconception care to new mothers could potentially be provided by Preventive Child Health Care services, this care is currently not routinely available in the Netherlands. The purpose of this study was to identify facilitators and barriers for implementation of interconception care in Preventive Child Health Care services. Methods We organized four focus groups in which Preventive Child Health Care physicians and nurses, related health care professionals and policymakers participated. A semi-structured interview approach was used to guide the discussion. The transcribed discussions were analyzed. Results All four groups agreed that several facilitators are present, such as the unique position to reach women and the expertise in preventive health care. Identified barriers include unfamiliarity with interconception care among patients and health care providers, as well as lack of consensus about the concept of interconception care and how it should be organized. A broad educational campaign, local adaptation, and general agreement or a guideline for standard procedures were recognized as important for future implementation. Conclusions for practice This study identifies potentially important facilitators and barriers for the implementation of interconception care in Preventive Child Health Care services or comparable pediatric settings. These factors should be considered and strategies developed to achieve successful implementation of interconception care.
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Affiliation(s)
- Meertien K Sijpkens
- Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ageeth N Rosman
- Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Konijnendijk AAJ, Boere-Boonekamp MM, Fleuren MAH, Haasnoot ME, Need A. What factors increase Dutch child health care professionals' adherence to a national guideline on preventing child abuse and neglect? CHILD ABUSE & NEGLECT 2016; 53:118-127. [PMID: 26687328 DOI: 10.1016/j.chiabu.2015.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 09/11/2015] [Accepted: 11/13/2015] [Indexed: 06/05/2023]
Abstract
Guidelines to support health care professionals in early detection of, and responses to, suspected Child Abuse and Neglect (CAN) have become increasingly widely available. Yet little is known about professionals' adherence to these guidelines or the determinants that affect their uptake. This study used a cross-sectional design to assess the adherence of Dutch Child Health Care (CHC) professionals to seven key activities described in a national guideline on preventing CAN. This study also examined the presence and strengths of determinants of guideline adherence. Online questionnaires were filled in between May and July 2013 by 164 CHC professionals. Adherence was defined as the extent to which professionals performed each of seven key activities when they suspected CAN. Thirty-three determinants were measured in relation to the guideline, the health professional, the organisational context and the socio-political context. Bivariate and multivariate regression analyses tested associations between determinants and guideline adherence. Most of the responding CHC professionals were aware of the guideline and its content (83.7%). Self-reported rates of full adherence varied between 19.5% and 42.7%. Stronger habit to use the guideline was the only determinant associated with higher adherence rates in the multivariate analysis. Understanding guideline adherence and associated determinants is essential for developing implementation strategies that can stimulate adherence. Although CHC professionals in this sample were aware of the guideline, they did not always adhere to its key recommended activities. To increase adherence, tailored interventions should primarily focus on enhancing habit strength.
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Affiliation(s)
- Annemieke A J Konijnendijk
- Institute for Innovation and Governance Studies, Departments of Public Administration, and Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Magda M Boere-Boonekamp
- Institute for Innovation and Governance Studies, Department of Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Margot A H Fleuren
- TNO, Department of Life Style, P.O. Box 3305, 2301 DA Leiden, The Netherlands
| | - Maria E Haasnoot
- Municipal Health Service GGD Twente, Department of Preventive Child Health Care, P.O. Box 1400, 7500 BK, Enschede, The Netherlands
| | - Ariana Need
- Institute for Innovation and Governance Studies, Department of Public Administration, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
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Vanneste Y, van de Loo M, Feron F, Rots – de Vries C, van de Goor I. Attitudes towards Addressing Medical Absenteeism of Students: A Qualitative Study among Principals and Special Education Needs Coordinators in Dutch Secondary Schools. PLoS One 2016; 11:e0148427. [PMID: 26845688 PMCID: PMC4742281 DOI: 10.1371/journal.pone.0148427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/18/2016] [Indexed: 11/19/2022] Open
Abstract
Background Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools’ perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. Methods A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. Findings The main reasons for schools to address medical absenteeism were their concerns about students’ well-being and future prospects and their wish to share these concerns with students’ parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers’ dialogue about medical absence with students and their parents, teachers’ follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. Conclusions MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools’ need to address medical absenteeism by providing a clear framework, an approach from concern rather than control, and socio-medical expertise through the collaboration with YHCPs. MASS can support schools to maximize the number of students graduating and to improve parental involvement in school. These outcomes may help to put the subject of addressing medical absenteeism on the agenda of all schools, and contribute to prioritization, support adoption and secure sustainable implementation and dissemination of MASS.
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Affiliation(s)
- Yvonne Vanneste
- Department of Youth Health Care, Regional Public Health Service West Brabant, Tilburg, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
- * E-mail:
| | - Marlou van de Loo
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Frans Feron
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Carin Rots – de Vries
- Department of Youth Health Care, Regional Public Health Service West Brabant, Tilburg, The Netherlands
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ien van de Goor
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Jambroes M, Lamkaddem M, Stronks K, Essink-Bot ML. Enumerating the preventive youth health care workforce: Size, composition and regional variation in the Netherlands. Health Policy 2015; 119:1557-64. [PMID: 26358246 DOI: 10.1016/j.healthpol.2015.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/31/2015] [Accepted: 08/03/2015] [Indexed: 11/25/2022]
Abstract
The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had >10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range 688-1007). All essential public health operations were provided and could be clustered in an operational or policy profile. The operational profile prevailed in all regions. Regional differences in the number of children per YHC professional were unrelated to the indicators of YHC need. The essential public health operations provided by the YHC workforce and the regional variations in children per YHC professional were not in line with indicators of YHC needs, indicating room for improvement of YHC workforce planning. The methodology applied in this study is probably relevant for use in other countries.
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Affiliation(s)
- Marielle Jambroes
- Academic Medical Center, Department of Public Health, J2, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Majda Lamkaddem
- Academic Medical Center, Department of Public Health, J2, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Karien Stronks
- Academic Medical Center, Department of Public Health, J2, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Marie-Louise Essink-Bot
- Academic Medical Center, Department of Public Health, J2, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
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Bezem J, Theunissen M, Buitendijk SE, Kocken PL. A novel triage approach of child preventive health assessment: an observational study of routine registry-data. BMC Health Serv Res 2014; 14:498. [PMID: 25339363 PMCID: PMC4226875 DOI: 10.1186/s12913-014-0498-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 10/06/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The coverage of preventive health assessments for children is pivotal to the system of preventive health screening. A novel method of triage was introduced in the Preventive Youth Health Care (PYHC) system in the Netherlands with an associated shift of tasks of professionals. Doctor's assistants carried out pre-assessments to identify children in need of follow-up assessment, whereas in the traditional approach all children would have been screened by a doctor or nurse. The accessibility and care delivery of this new PYHC system was studied. METHODS The new triage approach was compared to the traditional approach in 780 children undergoing PYHC assessment with the use of an observational retrospective study design. Outcomes were attendance of assessment appointments (accessibility of care) and referral of children to either extra PYHC assessment or external specialised care (delivery of preventive care). PYHC registry data were analysed. In two regions of the Netherlands, 390 children five to six years of age were randomly selected from the PYHC registries according to the socio-economic strata of the schools they attended. RESULTS When the triage and traditional approaches to PYHC were compared, we found similar attendance rates for assessment appointments, namely about 90%. As expected, 100% of the children in the traditional group were assessed by a PYHC doctor compared to 46% of the children in the triage group. Significantly fewer children were referred for extra PYHC assessment or for treatment by an external specialised care giver when a triage as opposed to the traditional assessment approach was used (19.6% vs. 45.9%). CONCLUSIONS The novel triage approach for preventive health assessment shows equal accessibility, but a different delivery of preventive care. A beneficial effect of the adoption of the triage approach is the opportunity to provide more attention from doctors and nurses to children at risk of health problems. However, lower referral rates of the triage approach may be explained by an under-identification of children with health problems. Further research is needed to document the health outcomes and the possible reduction of health care costs with a triage approach compared to traditional PYHC care.
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Affiliation(s)
- Janine Bezem
- />Department Preventive Youth Health Care, Municipal Health Service Gelderland-Midden, 6802 EJ Arnhem, The Netherlands
- />Department of Child Health, TNO, Leiden, The Netherlands
| | | | | | - Paul L Kocken
- />Department of Child Health, TNO, Leiden, The Netherlands
- />Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
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Impact of toilet hygiene training program: results from 11- to 16-year-old secondary school Turkish children. Int J Public Health 2014; 59:799-807. [PMID: 25173963 DOI: 10.1007/s00038-014-0595-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/17/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022] Open
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de Wilde JA, van Dommelen P, van Buuren S, Middelkoop BJC. Height of South Asian children in the Netherlands aged 0-20 years: secular trends and comparisons with current Asian Indian, Dutch and WHO references. Ann Hum Biol 2014; 42:38-44. [PMID: 24963814 DOI: 10.3109/03014460.2014.926988] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND People from Asian populations are generally shorter than other ethnic groups. It is unknown if current universal height references are suitable for affluent South Asian children in the Netherlands. AIMS To develop height-for-age charts for contemporary South Asian children aged 0-20 years living in the Netherlands, to evaluate secular trends, and to compare the charts with current Asian Indian, Dutch and WHO references. SUBJECTS AND METHODS A population-based study measured 3315 South Asian children aged 0-20 years between 2007-2010. Among this cohort, 6876 measurements were taken. Another 7388 measurements were taken of a historical cohort of 1078 children born between 1974-1976 (aged 0-18 years). RESULTS An upward trend in height was observed for South Asian children living in the Netherlands between 1992-2010. The height-for-age charts of the South Asian historical cohort were similar to current Asian Indian charts. South Asian children in the Netherlands were shorter than their Dutch contemporaries at every age; and these differences increased further during adolescence. Compared to the WHO height-for-age references, there were considerable discrepancies in height, with curves intersecting twice. CONCLUSION The discrepancies between the South Asian and Dutch and WHO height-for-age references indicate differences in growth patterns between the source populations.
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Affiliation(s)
- Jeroen A de Wilde
- Department of Youth Health Care, GGD (Community Health Service) Haaglanden , The Hague , The Netherlands
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de Wilde JA, Verkerk PH, Middelkoop BJC. Declining and stabilising trends in prevalence of overweight and obesity in Dutch, Turkish, Moroccan and South Asian children 3-16 years of age between 1999 and 2011 in the Netherlands. Arch Dis Child 2014; 99:46-51. [PMID: 24132042 DOI: 10.1136/archdischild-2013-304222] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In many developed countries, overweight and obesity prevalence seems to stabilise. The aim of this study was to determine trends between 1999 and 2011 in overweight and obesity prevalence, and mean Body Mass Index (BMI) z-score in Dutch, Turkish, Moroccan and Surinamese South Asian children in the Netherlands. DESIGN A cross-sectional population-based study with 136 080 measurements of height and weight of 73 290 children aged 3-16 years. BMI class and BMI z-score were determined with the latest International Obesity Taskforce (IOTF) criteria, with overweight defined as an adult BMI equivalent ≥ 25 and obesity ≥ 30. Time trends per year were analysed using logistic and linear regression analyses. RESULTS The prevalence of overweight in Dutch children declined from 13% to 11% (OR 0.960; 95% CI 0.954 to 0.965), but increased in Turkish children from 25% to 32% (OR 1.028; 95% CI 1.020 to 1.036). In Moroccan and Surinamese South Asian children, overweight rates were stable, but obesity prevalence decreased (OR 0.973; 95% CI 0.957 to 0.989, OR 0.964; 95% CI 0.943 to 0.985, respectively) as well as the mean BMI z-score (B=-0.010; 95% CI -0.014 to -0.006, B=-0.010; 95% CI -0.016 to -0.004). In Turkish children, trends limited to the period 2007-2011 showed no statistically significant relationship for all outcome measures. CONCLUSIONS The decrease in obesity prevalence in Dutch, Moroccan and Surinamese South Asian children suggests that overweight children became less adipose. The stabilising trend in overweight and obesity prevalence in Turkish children since 2007 may signify a levelling off for this ethnic group.
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Affiliation(s)
- J A de Wilde
- Department of Youth Health Care, Municipal Health Service The Hague (GGD Den Haag), , The Hague, The Netherlands
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Jong MC, van Vliet M, Huttenhuis S, van der Veer D, van den Heijkant S. Attitudes toward integrative paediatrics: a national survey among youth health are physicians in The Netherlands. Altern Ther Health Med 2012; 12:4. [PMID: 22244450 PMCID: PMC3293769 DOI: 10.1186/1472-6882-12-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 01/16/2012] [Indexed: 11/21/2022]
Abstract
Background Integrative Medicine (IM) is an emerging field in paediatrics, especially in the USA. The purpose of the present study was to assess the attitudes and beliefs of Youth Health Care (YHC) physicians in the Netherlands toward IM in paediatrics. Methods In October 2010, a link to an anonymous, self-reporting, 30-item web-based questionnaire was mailed to all members of the Dutch Organisation of YHC physicians. The questionnaire included questions on familiarity with IM, attitudes towards Integrative Paediatrics (IP), use and knowledge of Complementary and Alternative Medicine (CAM), demographic and practice characteristics. Results A total of 276 YHC physicians (response rate of 27%) responded to the survey. Of the respondents, 52% was familiar with IM and 56% had used some kind of CAM therapy during the past 2 years, of which self-medicated herbal and/or homeopathic remedies (61%) and supplements (50%) were most frequently mentioned. Most of the YHC physicians (62%) seldom asked parents of clients about CAM use. One third of the YHC physicians recommended CAM to their clients. In general, about 50% or more of the respondents had little knowledge of CAM therapies. Predictors for a positive attitude towards IP were familiarity with IM, own CAM use, asking their clients about CAM use and practising one or more forms of CAM therapy. Logistic regression analysis showed that the following factors were associated with a higher recommendation to CAM therapies: own CAM use (odds ratio (OR) = 3.8; 95% confidence interval (CI) = 2.1-6.9, p = 0.001) and practising CAM (OR 4.4; 95% CI = 1.6-11.7, p = 0.003). Conclusions In general Dutch YHC physicians have a relative positive attitude towards IP; more than half of the respondents used one or more forms of CAM and one third recommended CAM therapies. However, the majority of YHC physicians did not ask their clients about CAM use and seemed to have a lack of knowledge regarding CAM.
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