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Barrett EO, Laholt H, Lorem GF, Wang CEA. Exploring public health nurses' acceptability of clinical assessment tools in a Norwegian child health centre. Prim Health Care Res Dev 2024; 25:e10. [PMID: 38343358 PMCID: PMC10894717 DOI: 10.1017/s146342362400001x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Infants' symptoms of mental struggle are often diffuse and undifferentiated, and health services do not identify many infants at risk of poor development. However, primary health care is advantageous for early identification, given there are frequent consultations during the infant's first two years. Health policy encourages using evidence-based screening but use varies in primary health care. The Alarm Distress Baby Scale (ADBB) is an assessment tool targeting social withdrawal in infants 2-24 months of age. AIM To explore contextual factors related to public health nurses' (PHNs) acceptability of clinical assessment tools in a Norwegian child health centre. METHODS Prior to an upcoming ADBB training, we used focus group discussions with PHNs to explore their views on their professional role and practice and how this concurs with using assessment tools. FINDINGS Thematic analysis resulted in the following themes: (1) A Role requiring Supporting the Parents and Safeguarding the Infant; (2) The Challenge of Interpreting Infant Expressions; and (3) Organisational Preconditions for Accepting New Methods. CONCLUSION Our findings show that PHNs regard assessment tools as an aid to detect infants at risk, but that systematic use of such tools can hinder their ability to be flexible, egalitarian, and resource-focused. We also find that acceptability of assessment tools requires a system for continuous training and a well-established referral routine.
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Affiliation(s)
- Elisabeth Ovanger Barrett
- Faculty of Health Sciences - Department of Psychology/Specialist in Clinical Community Psychology, UiT - The Arctic University of Norway, Municipality of Tromsø, Norway
| | - Hilde Laholt
- Faculty of Health Sciences - Department of Health and Care Sciences, UiT - The Arctic University of Norway, Municipality of Tromsø, Norway
| | - Geir Fagerjord Lorem
- Faculty of Health Sciences - Department of Psychology, UiT - The Arctic University of Norway, Municipality of Tromsø, Norway
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O'Hara PT, Talero Cabrejo P, Earland TV. Early detection of neurodevelopmental disorders in paediatric primary care: A scoping review. Fam Pract 2023:cmad072. [PMID: 37491000 DOI: 10.1093/fampra/cmad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Earlier detection of children at risk for neurodevelopmental disorders is critical and has longstanding repercussions if not addressed early enough. OBJECTIVES To explore the supporting or facilitating characteristics of paediatric primary care models of care for early detection in infants and toddlers at risk for neurodevelopmental disorders, identify practitioners involved, and describe how they align with occupational therapy's scope of practice. METHODS A scoping review following the Joanna Briggs Institute framework was used. PubMed Central, Cumulative Index to Nursing & Allied Health Literature, and Scopus databases were searched. The search was conducted between January and February 2022. Inclusion criteria were: children aged 0-3 years old; neurodevelopmental disorders including cerebral palsy (CP) and autism spectrum disorder (ASD); models of care used in the paediatric primary care setting and addressing concepts of timing and plasticity; peer-reviewed literature written in English; published between 2010 and 2022. Study protocol registered at https://doi.org/10.17605/OSF.IO/MD4K5. RESULTS We identified 1,434 publications, yielding 22 studies that met inclusion criteria. Models of care characteristics included the use of technology, education to parents and staff, funding to utilize innovative models of care, assessment variability, organizational management changes, increased visit length, earlier timeline for neurodevelopmental screening, and collaboration with current office staff or nonphysician practitioners. The top 4 providers were paediatricians, general or family practitioners, nurse/nurse practitioners, and office staff. All studies aligned with occupational therapy health promotion scope of practice and intervention approach yet did not include occupational therapy within the paediatric primary care setting. CONCLUSIONS No studies included occupational therapy as a healthcare provider that could be used within the paediatric primary care setting. However, all studies demonstrated models of care facilitating characteristics aligning with occupational therapy practice. Models of care facilitating characteristics identified interdisciplinary staff as a major contributor, which can include occupational therapy, to improve early detection within paediatric primary care.
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Affiliation(s)
- Paulette T O'Hara
- Department of Public Health, California Children's Services, Los Angeles, CA, United States
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
| | - Pamela Talero Cabrejo
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
| | - Tracey V Earland
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
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Riley BRW, de Sam Lazaro SL. Role of Occupational Therapy in Pediatric Primary Care: Promoting Childhood Development. Am J Occup Ther 2021; 75:23081. [PMID: 34817597 DOI: 10.5014/ajot.2021.756002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Occupational therapy practitioners have the opportunity to promote development for all children as new service delivery models are established for pediatric primary care. Three action steps are identified: (1) advocacy for legislation that requires developmental screenings and surveillance, (2) support of culturally responsive developmental monitoring, and (3) building evidence for occupational therapy in primary care settings. This article describes the role of occupational therapy practitioners on pediatric interprofessional teams in encouraging family capacity within the scope of health promotion and universal developmental monitoring.
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Affiliation(s)
- Bonnie R W Riley
- Bonnie R. W. Riley, OTD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY;
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Zachry AH, Jones T, Flick J, Richey P. The Early STEPS Pilot Study: The Impact of a Brief Consultation Session on Self-reported Parenting Satisfaction. Matern Child Health J 2021; 25:1923-1929. [PMID: 34613553 DOI: 10.1007/s10995-021-03234-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Evidence-based parenting interventions can augment parental knowledge and skills to reduce parental stress and increase self-efficacy, leading to improved developmental outcomes for children. However, parenting interventions are often multi-session and require considerable time commitments from parents and primary care physicians. We conducted a pilot study to evaluate the effect of a brief consultation session on self-reported parental satisfaction and to assess the feasibility and effectiveness of incorporating occupational therapists (OTs) into a low-income urban pediatric primary care setting to conduct developmental screenings. METHODS OTs conducted one 45-min consultation on positive parenting practices and promoting child development with parents in a pediatric primary care practice. A one group pretest-posttest design with 6-month follow-up was utilized. Participants included 55 families with 60 children, ages 2 to 65 months 30 days. The primary outcome measure was the change in Parenting Sense of Competence Scale (PSOC) scores from baseline to 6-month follow-up. Additional outcomes were screening results, referral numbers, and follow through in obtaining early intervention services. RESULTS The paired difference between PSOC scores at baseline and 6 months indicated a significant increase in parenting satisfaction (p < 0.0001). Of 41 children referred, 26 were eligible and obtained services, 12 were lost to follow-up, and 3 did not qualify for services. DISCUSSION Our preliminary findings suggest one consultation session on positive parenting practices and promoting child development may increase parenting satisfaction. Moreover, OTs can reduce the burden on primary care physicians by providing screenings, consultations, and follow-up. Further research is warranted to evaluate these findings.
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Affiliation(s)
- Anne H Zachry
- Department of Occupational Therapy, University of Tennessee Health Science Center, 930 Madison Ave, Suite 616, Memphis, TN, 38163, USA.
| | - Tamekia Jones
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap St., Memphis, TN, 38103, USA
| | - Jami Flick
- Department of Occupational Therapy, University of Tennessee Health Science Center, 930 Madison Ave, Suite 603, Memphis, TN, 38163, USA
| | - Phyllis Richey
- Department of Preventative Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN, 38163, USA
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Visser‐Bochane M, Luinge M, Dieleman L, Schans C, Reijneveld S. The Dutch well child language screening protocol for 2-year-old children was valid for detecting current and later language problems. Acta Paediatr 2021; 110:556-562. [PMID: 32585043 PMCID: PMC7891318 DOI: 10.1111/apa.15447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 11/30/2022]
Abstract
Aim A little is known about predictive validity of and professionals' adherence to language screening protocols. This study assessed the concurrent and predictive validity of the Dutch well child language screening protocol for 2‐year‐old children and the effects of protocol deviations by professionals. Methods A prospective cohort study of 124 children recruited and tested between October 2013 and December 2015. Children were recruited from four well child clinics in urban and rural areas. To validate the screening, we assessed children's language ability with standardised language tests following the 2‐year screening and 1 year later. We assessed the concurrent and predictive validity of the screening and of protocol deviations. Results At 2 years, the sensitivity and specificity of the language screening were 0.79 and 0.86, and at 3 years 0.82 and 0.74, respectively. Protocol deviations by professionals were rare (7%) and did not significantly affect the validity of the screening. Conclusion The language screening protocol was valid for detecting current and later language problems. Deviations from the protocol by professionals were rare and did not affect the concurrent nor predictive validity of the protocol. The 2‐year language screening supports professionals working in preventive child health care and deserves wider implementation in well child care.
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Affiliation(s)
- Margot Visser‐Bochane
- Research Group Healthy Ageing Allied Health Care and Nursing Hanze University Groningen, Applied Sciences Groningen The Netherlands
| | - Margreet Luinge
- Research Group Healthy Ageing Allied Health Care and Nursing Hanze University Groningen, Applied Sciences Groningen The Netherlands
- Department of Otorhinolaryngology Head & Neck Surgery University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Liesbeth Dieleman
- Department of Preventive Child Health Care Municipal Health Service Zeeland Goes The Netherlands
| | - Cees Schans
- Research Group Healthy Ageing Allied Health Care and Nursing Hanze University Groningen, Applied Sciences Groningen The Netherlands
- Department of Health Sciences University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
- Department of Rehabilitation Medicine University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
| | - Sijmen Reijneveld
- Department of Health Sciences University Medical Center GroningenUniversity of Groningen Groningen The Netherlands
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Jain K, Solomon J, Ramachandran S. Knowledge, attitude and practices on developmental surveillance and screening among health professionals in Indian health care settings: An exploratory sequential mixed methods study. J Pediatr Rehabil Med 2021; 14:55-63. [PMID: 33492251 DOI: 10.3233/prm-190649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the knowledge, attitude and practices of health care professionals in pediatric settings on developmental surveillance and screening programs and also to identify the barriers and facilitators during its implementation. METHODS The data were collected from health professionals involved in pediatric developmental care, practicing in various hospitals, clinics and nursing homes in a suburban city on west coast of Southern India. The study involved cross-sectional exploratory sequential mixed method design which included a quantitative questionnaire survey on health professionals (n= 52) followed by qualitative face-to-face interviews with chosen respondents who participated in the survey (n= 8). The survey data are reported with descriptive statistics, and interview data are subjected to inductive content analysis for deriving codes, categories and themes. RESULTS The study results indicate that health professionals involved in pediatric developmental care in Indian health care settings have fair knowledge and a favorable attitude towards the use of developmental surveillance and screening. Furthermore, the facilitators and barriers of implementation have been reported. The strategies outlined by interview respondents to improve adherence to implementation have been discussed. CONCLUSIONS The practice of developmental surveillance and screening is limited despite favorable knowledge and attitude among health professionals in pediatric developmental care and is dependent on health care organizational setup.
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Chandradasa M, Rathnayake L. Retained primitive reflexes in children, clinical implications and targeted home-based interventions. Nurs Child Young People 2020; 32:37-42. [PMID: 31468794 DOI: 10.7748/ncyp.2019.e1132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2018] [Indexed: 11/09/2022]
Abstract
This article discusses problems such as learning difficulties and behavioural problems that children may experience when they have retained primitive reflexes, which are typically only present in the first few months of life. The authors outline different types of primitive reflex present in infants and how each may affect a child when retained beyond the time when they are normally inhibited. Where relevant health professionals with expertise in this area are not available, children's nurses may need to assess and manage children with retained reflexes. This article explains how a nurse can assess a child for each primitive reflex and describes exercises that can be taught to a child and his or her parents to carry out at home to reintegrate the reflex.
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Affiliation(s)
- Miyuru Chandradasa
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka and consultant child and adolescent psychiatrist, Colombo North Teaching Hospital, Ragama, Sri Lanka
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D'Aprano A, Johnston H, Jarman R, Jeyaseelan D, Chan YP, Johansen K, Finch S. Practitioners' perceptions of the ASQ-TRAK developmental screening tool for use in Aboriginal children: A preliminary survey. J Paediatr Child Health 2020; 56:94-101. [PMID: 31132192 DOI: 10.1111/jpc.14502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine health practitioners' experience of using the culturally adapted Ages and Stages Questionnaire - Talking about Raising Aboriginal Kids (ASQ-TRAK) and the Ages and Stages Questionnaire-3 (ASQ-3) with Australian Aboriginal families and their perception about parents' acceptability and understanding of the instruments. METHODS We surveyed a convenience sample of practitioners who had used both the ASQ-TRAK and the ASQ-3 developmental screening tools with Aboriginal children in the Northern Territory and South Australia. We compared their experience and perception about parents' acceptability and understanding of both instruments. RESULTS All 38 respondents used the ASQ-3 and 35 the ASQ-TRAK; 100% rated the ASQ-TRAK as more acceptable and easier to understand for parents compared with 68% (P < 0.001) and 52.6% (P < 0.001), respectively, for the ASQ-3. A greater proportion of respondents were satisfied using the ASQ-TRAK (100%) than the ASQ-3 (65.7%) (P = 0.003). A higher proportion indicated that the ASQ-TRAK was respectful (85.3% compared with ASQ-3 27.8%, P < 0.001), culturally relevant (70.6% compared to 16.2%, P < 0.001) and engaging (76.5% compared to 16.2%, P < 0.001). Qualitative exploration of respondents' comments supported the quantitative findings. The ASQ-TRAK was considered more culturally appropriate, engaging and useful. CONCLUSIONS Our findings demonstrate that the culturally adapted ASQ-TRAK is preferred to the ASQ-3 by health practitioners in the Australian Aboriginal context. Failing to address cultural and linguistic factors and applying measurement tools developed for one population to another, is problematic in any setting. While further research is required to explore parents' experience directly, these data provide support for the ASQ-TRAK to be used in this context.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Policy and Equity Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Menzies School of Health Research, Centre for Child Development and Education, Darwin, Northern Territory, Australia
| | - Hannah Johnston
- Office of Disability, Top End Remote, Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Rebecca Jarman
- Centre for Disease Control, Department of Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Deepa Jeyaseelan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Child and Family Health Service, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Yee Pei Chan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Kimberly Johansen
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sue Finch
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Guilé JM, Tissot C, Boissel L. Interdisciplinary assessment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:173-181. [PMID: 32977876 DOI: 10.1016/b978-0-444-64148-9.00013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Interdisciplinary assessment (IA) is defined as the integration of clinical contributions by healthcare professionals from distinct disciplines into a comprehensive diagnostic and prognostic evaluation. This process requires the professionals to independently and simultaneously consider and gage clinical information collected via a variety of methods and from a variety of informants. A shared perception of the clinical situation is progressively achieved via team meetings. IA helps clinicians to overcome the many challenges posed in today's context for assessment and treatment planning in the field of neurodevelopmental disorders. Most national and international guidelines recommend the inclusion of IA in the diagnostic workup for complex cases (e.g., autism spectrum and attention deficit hyperactivity disorder). Hence, IA should always be part of the neurodevelopmental disorder diagnostic process in children in general and preterm infants in particular.
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Affiliation(s)
- Jean-Marc Guilé
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France; Psychiatry Residency Program, Faculty of Medicine, Université Picardie Jules Verne, Amiens, France; Child and Adolescent Psychiatry Department, Centre Hospitalier Philippe Pinel, Amiens, France; Department of Psychiatry, McGill University, Montreal, QC, Canada.
| | - Chloé Tissot
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France
| | - Laure Boissel
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Amiens-Picardie, Salouel, France; Psychiatry Residency Program, Faculty of Medicine, Université Picardie Jules Verne, Amiens, France
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Valla L, Slinning K, Wentzel‐Larsen T. Parent satisfaction before and after implementing of a developmental screening tool in nine well-baby clinics in Norway. Acta Paediatr 2019; 108:1811-1816. [PMID: 30924970 DOI: 10.1111/apa.14802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of the study was to compare parental satisfaction items before and after the implementation of The Ages & Stages Questionnaires (ASQ) as part of the health check-up. METHODS ASQ was implemented in regular health check-ups of infants up to two years of age in 9 Norwegian well-baby clinics. After the infant's two years' health check-ups, a questionnaire-based survey among 652 families before and 562 families after intervention was conducted. Descriptive analyses and ordinal logistic regression were used to report and compare parental satisfaction items before and after the project. RESULTS Parents reported high satisfaction with well-baby services both before and after the implementation of ASQ, and ninety-six per cent recommended other well-baby clinics to use ASQ. Some significant differences appeared, before the implementation of ASQ, parents were more satisfied with the support they received regarding parenting and child development in general and information about the child's physical health. After ASQ was implemented, parents were significantly more satisfied with the information they received about 'the child's mental health'. CONCLUSION Developmental screening in well-baby clinics in Norway is acceptable among parents with young children. The use of standardised instruments must not come at the expense of listening to parents' concerns.
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Affiliation(s)
- Lisbeth Valla
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP) Oslo Norway
- Oslo Metropolitan University Oslo Norway
| | - Kari Slinning
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP) Oslo Norway
- Department of Psychology University of Oslo Oslo Norway
| | - Tore Wentzel‐Larsen
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway (RBUP) Oslo Norway
- Norwegian Centre for Violence and Traumatic Stress Studies Oslo Norway
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Gellasch P. The Developmental Screening Behaviors, Skills, Facilitators, and Constraints of Family Nurse Practitioners in Primary Care: A Qualitative Descriptive Study. J Pediatr Health Care 2019; 33:466-477. [PMID: 30878265 DOI: 10.1016/j.pedhc.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/07/2019] [Accepted: 01/14/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Researchers have found that many primary care providers are not following developmental screening recommendations. Few studies exist on the screening behaviors of advanced practice nurses. METHODS A qualitative descriptive study explored the screening behaviors, skills, and environmental facilitators/constraints of 24 family nurse practitioners (FNPs) who cared for pediatric patients from birth to 5 years of age in primary care settings. An inductive approach to content analysis was used to interpret the data. RESULTS Five main themes emerged: (a) Developmental Screening Behaviors During Well-Child Visits, (b) Developmental Screening Behaviors When a Concern Was Raised, (c) Need for Additional Developmental Screening Skills, (d) Factors That Support Developmental Screening, and (e) Factors That Limit Developmental Screening. Sixteen subthemes supported the main themes. DISCUSSION Most FNPs were not using standardized tools. Behaviors mainly consisted of actions that were informal. FNPs were not familiar with current recommendations, and they had difficulty describing most instruments.
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Smith-Nielsen J, Lønfeldt N, Guedeney A, Væver MS. Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care: feasibility, acceptability, and predictors of professionals' adherence to guidelines. Int J Nurs Stud 2017; 79:104-113. [PMID: 29223624 DOI: 10.1016/j.ijnurstu.2017.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/12/2017] [Accepted: 11/14/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infant socioemotional development is often held under informal surveillance, but a formal screening program is needed to ensure systematic identification of developmental risk. Even when screening programs exist, they are often ineffective because health care professionals do not adhere to screening guidelines, resulting in low screening prevalence rates. OBJECTIVES To examine feasibility and acceptability of implementing universal screening for infant socioemotional problems with the Alarm Distress Baby Scale in primary care. The following questions were addressed: Is it possible to obtain acceptable screening prevalence rates within a 1-year period? How do the primary care workers (in this case, health visitors) experience using the instrument? Are attitudes toward using the instrument related to screening prevalence rates? DESIGN A longitudinal mixed-method study (surveys, data from the health visitors' digital filing system, and qualitative coding of answers to open-ended questions) was undertaken. SETTING AND PARTICIPANTS Health visitors in three of five districts of the City of Copenhagen, Denmark (N=79). METHODS We describe and evaluate the implementation process from the date the health visitors started the training on how to use the Alarm Distress Baby Scale to one year after they began using the instrument in practice. To monitor screening prevalence rates and adherence to guidelines, we used three data extractions (6, 9, and 12 months post-implementation) from the electronic filing system. Surveys including both quantitative and open-ended questions (pre- and post-implementation) were used to examine experiences with and attitudes towards the instrument. Descriptive and inferential statistical and qualitative content analyses were used. RESULTS Screening prevalence rates increased during the first year: Six months after implementation 47% (n=405) of the children had been screened; 12 months after implementation 79% (n=789) of the children were screened (the same child was not counted more than once). Most (92%) of the health visitors reported that the instrument made a positive contribution to their work. The majority (81%) also reported that it posed a challenge in their daily work at least to some degree. The health visitors' attitudes (positive and negative) toward the Alarm Distress Baby Scale, measured 7 months post-implementation, significantly predicted screening prevalence rates 12 months post-implementation. CONCLUSIONS Adding the Alarm Distress Baby Scale to an established surveillance program is feasible and accepTable Screening prevalence rates may be related to the primary care worker's attitude toward the instrument, i.e. successful implementation relies on an instrument that adds value to the work of the screener.
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Affiliation(s)
| | - Nicole Lønfeldt
- Child and Adolescent Mental Health Center, Mental Health Services, Denmark
| | - Antoine Guedeney
- Hospital Bichat Claude Bernard APHP, University Denis Diderot Paris, INSERM U 1178 CERP, France
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Christian BJ. Translational Research--New Evidence for Guiding Intervention Development to Improve the Lives of Children and their Families. J Pediatr Nurs 2016; 31:214-6. [PMID: 26920635 DOI: 10.1016/j.pedn.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 01/13/2016] [Indexed: 10/22/2022]
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