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Radhamony R, Cross WM, Townsin L, Banik B. Culturally and Linguistically Diverse Community Access and Utilisation of the Mental Health Service: An Explanation Using Andersen's Behavioural Model. Issues Ment Health Nurs 2024; 45:758-765. [PMID: 38954511 DOI: 10.1080/01612840.2024.2359602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Andersen's Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses' cultural competence can influence the Victorian CALD community members' mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses' cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Wendy M Cross
- School of Health, Federation University, Ballarat, Australia
| | - Louise Townsin
- School of Health, Federation University, Ballarat, Australia
- Research Office, Torrens University, Adelaide, South Australia, Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, University of New England, Armidale, New South Wales, Australia
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Bentley SE, Garg P, Gudes O, Hurwitz R, Vivekanandarajah S, So LYL. Access to child developmental assessment services in culturally and linguistically diverse metropolitan Sydney: a retrospective cohort analysis. BMC Health Serv Res 2024; 24:342. [PMID: 38486262 PMCID: PMC10941404 DOI: 10.1186/s12913-024-10800-y] [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] [Received: 04/18/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Despite the increasing prevalence of neurodevelopmental disorders (NDD), data regarding access to child development services have remained limited globally. Long wait times are a major barrier to developmental assessments, impacting on care and outcomes. The aim is to retrospectively analyse the demographic profile and prioritisation of patients seen at a child developmental assessment service (CDAS) in a vulnerable region of Sydney, and explore factors affecting wait times. METHODS Data was collated and analysed for 2354 patients from 2018 to 2022. Socio-Economic Indexes for Areas (SEIFA) were collated from the Australian Bureau of Statistics. Descriptive statistics were used for demographic data and various statistical methods were used to analyse the relationships and impact of factors likely to affect wait lists. RESULTS The median age was 51 months (IQR41-61) and males comprised 73.7% of the cohort. 64% of children were from culturally and linguistically diverse backgrounds (CALD) and 47% lived in the most disadvantaged suburbs. The median wait time was 302.5 days (IQR175-379) and 70% of children were seen within 12 months. CALD patients and children over 5-years had shorter wait times. Most children with Global Developmental Delay (GDD) were from the lowest four SEIFA deciles and waited longer for an appointment. 42.6% were seen within the priority allocated time or sooner. Children with ASD and/or severe GDD were prioritised to be seen earlier. Overall, the study could not demonstrate any difference in the wait times according to the prioritisation groups. CONCLUSION This study provides insights into the profile, prioritisation processes and wait lists of children seen by CDAS in South Western Sydney with high rates of social vulnerability and presents an argument to discuss benchmarking targets with service providers. It identifies the need to prioritise children living in suburbs with socioeconomic disadvantage and refine prioritisation and data collection processes to improve wait times.
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Affiliation(s)
- Sibella E Bentley
- The Children's Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
- University of Notre Dame Australia School of Medicine, Sydney, Australia.
| | - Pankaj Garg
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
- Department of Medicine & Health, University of New South Wales, Sydney, Australia
| | - Ori Gudes
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Romy Hurwitz
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
| | - Sinthu Vivekanandarajah
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
| | - Lydia Y L So
- Department of Community Paediatrics, South Western Sydney Local Health District Health Services Building Level 3, Liverpool, NSW, 2170, Australia
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Pearson E, Opoku MP. 'From my world to yours…': exploring the availability of social networks among parents from culturally diverse backgrounds caring for children with developmental disabilities in Australia. PSYCHOL HEALTH MED 2024; 29:386-397. [PMID: 37357406 DOI: 10.1080/13548506.2023.2229242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
This paper reports findings from an ethnographic study of families from culturally and linguistically diverse (CALD) families in Australia caring for children with disability. The study aimed to contribute insights into the unique experiences, challenges and supports that characterise experiences of families of a child with disability living in a country where the mainstream culture is different from their own. Four families from different cultural backgrounds participated in the study over a period of nine months. During this time, they participated in a series of semi-structured interviews during which they shared their encounters with formal early intervention services and reflected on important informal supports. Findings presented here indicate three key areas associated with accessing informal supports that can pose challenges for families who hold values that are different from those of the dominant culture: lack of social support; cultural adaptations, and socialization problems and coping strategies. The findings indicate that formal services could ameliorate feelings of social isolation by enabling parents to access informal supports such as parenting groups.
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Affiliation(s)
- Emma Pearson
- Curriculum and Method of Instruction (CEDU), College of Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maxwell Peprah Opoku
- Special Education Department, College of Education, United Arab Emirates University, Al Ain, United Arab Emirates
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House E, Xu H, Taki S, Denney‐Wilson E, Baur L, Wen LM. Mothers' sociodemographic factors and use of health professionals for child feeding advice. MATERNAL & CHILD NUTRITION 2024; 20:e13586. [PMID: 37932246 PMCID: PMC10750020 DOI: 10.1111/mcn.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/12/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
This study examined sociodemographic factors associated with mothers seeking child feeding advice from health professionals (HPs). Cross-sectional analysis of survey data from linked randomized controlled trials was conducted. Surveys asked which sources of feeding information mothers used when their child was 6 months and 5 years old. Logistic regression was used to examine associations between sociodemographic characteristics and use of information from HPs. Here, 947 and 405 mothers completed 6-month and 5-year surveys, respectively. At 6 months, multiparous mothers were less likely to seek advice from child and family health nurses (CFHNs) (adjusted odds ratio [AOR]: 0.558, 95% confidence interval [95% CI]: 0.416-0.749) and other HPs (AOR: 0.706, 95% CI: 0.542-0.919), unmarried mothers were less likely to seek advice from other HPs (AOR: 0.582, 95% CI: 0.342-0.990). At 5 years, mothers with household income ≥$80,000 p.a. were less likely to seek advice from CFHNs (AOR: 0.514, 95% CI: 0.302-0.875) and working mothers less likely to seek advice from general practitioners (GPs) (AOR: 0.581, 95% CI: 0.374-0.905). Mothers born in Australia were less likely to seek information from CFHNs (AOR: 0.462, 95% CI: 0.257-0.833) and GPs (AOR: 0.431, 95% CI: 0.274-0.677). There was a greater likelihood that multiparous mothers (AOR: 2.114, 95% CI: 1.272-3.516) and mothers of children whose fathers had not attended university (AOR: 2.081, 95% CI: 1.256-3.449) had never sought advice from CFHNs, and that mothers who had not attended university (AOR: 1.769, 95% CI: 1.025-3.051), multiparous (AOR: 1.831, 95% CI: 1.105-3.035) and employed (AOR: 2.058, 95% CI: 1.135-3.733) mothers had never sought advice from other HPs. Understanding sociodemographic factors associated with seeking child feeding advice from HPs may inform priorities for engaging families in health promotion.
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Affiliation(s)
- Eve House
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
| | - Huilan Xu
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
| | - Sarah Taki
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
| | - Elizabeth Denney‐Wilson
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Susan Wakil School of Nursing and MidwiferyFaculty of Medicine and Health, University of SydneySydneyNSWAustralia
| | - Louise Baur
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Specialty of Child and Adolescent HealthSydney Medical School, Faculty of Medicine and Health, The University of SydneySydneyNSWAustralia
| | - Li M. Wen
- Sydney School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
- NHMRC Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH‐Translate)SydneyNSWAustralia
- Sydney Institute for WomenChildren and Their Families, Sydney Local Health DistrictSydneyNSWAustralia
- Health Promotion UnitPopulation Health Research & Evaluation Hub, Sydney Local Health DistrictSydneyNSWAustralia
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Burman C, Mendoza Diaz A, Leslie A, Goldthorp K, Jubb B, Simms AR, Eapen V. Critical success factors for school-based integrated health care models: Learnings from an Australian example. Health Promot J Austr 2023; 34:775-783. [PMID: 36538268 DOI: 10.1002/hpja.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/05/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
ISSUES ADDRESSED Integrated school-based health services have the potential to address the unmet health needs of children experiencing disadvantage, yet these models remain poorly evaluated. The current article examines an integrated social and health care hub located on the grounds of a regional Australian public primary school, the Our Mia Mia Wellbeing Hub, to identify critical success factors for this service and others like it. METHODS Semi-structured qualitative interviews were conducted with N = 55 multi-sector stakeholders comprising parents, students, school staff, social and health care providers, and local Aboriginal community members. Interview transcripts were analysed according to a grounded theory approach. RESULTS Six themes emerged from the analysis, reflecting important success factors for the model: service accessibility; service coordination; integration of education and health systems; trust; community partnerships; and perceptions of health. CONCLUSIONS Findings highlighted Our Mia Mia as a promising model of care, yet also revealed important challenges for the service as it responds to the varied priorities of the stakeholders it serves. SO WHAT?: Through capturing the perspectives of a large number of stakeholders, the current study provides valuable insight into key challenges and success factors for Our Mia Mia; these learnings can guide the development of other emerging school-based health services and integrated care hubs.
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Affiliation(s)
- Charlotte Burman
- BestSTART-SWS, Ingham Institute of Applied Medical Research, Nowra, NSW, Australia
| | - Antonio Mendoza Diaz
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
- Academic Unit of Child Psychiatry, Infant, Child and Adolescent Mental Health Service, NSW, Australia
| | - Andrew Leslie
- Nowra East Public School, Nowra, NSW, Australia
- Our Mia Mia Wellbeing Hub, Nowra, NSW, Australia
| | | | - Brendan Jubb
- Our Mia Mia Wellbeing Hub, Nowra, NSW, Australia
| | | | - Valsamma Eapen
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
- Academic Unit of Child Psychiatry, Infant, Child and Adolescent Mental Health Service, NSW, Australia
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Wagner L, Corona L, Khan N, Hooper M, Dixon A, Munoz Lavanderos A, Zheng Z, Sarkar N, Sarkar N, Warren Z. Development of an App for Tracking Family Engagement With Early Intervention Services: Focus Groups and Pilot Evaluation Study. JMIR Hum Factors 2023; 10:e45957. [PMID: 37698912 PMCID: PMC10523211 DOI: 10.2196/45957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Expedient access to early intervention (EI) systems has been identified as a priority for children with developmental delays, identified disabilities, and other special health care needs. Despite the mandated availability of EI, it remains challenging for families to navigate referral processes and establish appropriate services. Such challenges disproportionately affect families from traditionally underserved communities. Mobile health apps can improve clinical outcomes, increase accessibility to health services, and promote adherence to health-related interventions. Though promising, the implementation of apps within routine care is in its infancy, with limited research examining the components of what makes an effective app or how to reach families most impacted by inequities in health care delivery. OBJECTIVE In study 1, we conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In study 2, focus group findings informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. METHODS In study 1, the focus groups included 29 participants from 4 shareholder groups. Targeted sampling was used to recruit participants from traditionally underrepresented groups. Focus group questions sought information about barriers families experience as they navigate the EI system, ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. Focus group procedures were informed by the Consolidated Framework for Implementation Research framework. In study 2, a pilot app was developed. The app was tested with a sample of 5 families of young children involved in the EI system. Families provided information on app functionality and usability. RESULTS Qualitative analysis revealed a desire for increased communication and information about the process of accessing EI services, potential utility of an app for communication purposes, and clear recommendations for app features. Insights from focus groups were used to inform the development of the Family on Track app and related implementation supports. App features included survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports include a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support. Field testing provided preliminary information about app usability, including identifying future directions. CONCLUSIONS The results of this study could support the development of a new way for the EI system to communicate and connect with families, provide families with a means to communicate satisfaction and frustration, and access the supports they need to be active participants in their child's care.
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Affiliation(s)
- Liliana Wagner
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Laura Corona
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Nibraas Khan
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Madison Hooper
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Alexa Dixon
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ambar Munoz Lavanderos
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Zhaobo Zheng
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | | | - Nilanjan Sarkar
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
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Hussain A, John JR, Dissanayake C, Frost G, Girdler S, Karlov L, Masi A, Alach T, Eapen V. Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia. BMC Pediatr 2023; 23:415. [PMID: 37612588 PMCID: PMC10463473 DOI: 10.1186/s12887-023-04236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The age at which parents or caregivers first develop concerns about their child's development has significant implications on formal diagnosis and intervention. This study aims to determine the sociocultural factors that are associated with the age and type of first concern reported by parents of autistic children among culturally and linguistically diverse (CALD) communities in Australia. We also assessed whether sociocultural factors predict autism traits measured in terms of social affect (SA), restricted and repetitive behaviours (RRB), and calibrated severity scores (CSS). METHODS This study is a secondary data analysis of the data collected from six Autism Specific Early Learning and Care Centres (ASELCCs) as part of the Autism Co-operative Research Centre (CRC) program between 2015 and 2019. Data analysed in this study included a family history questionnaire with sociodemographic and sociocultural information, parent-reported age and type of first concern, and clinician/researcher administered Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) which includes standardised domain-wise scores of social affect (SA) and restricted and repetitive behaviours (RRB) as well as calibrated severity scores (CSS), a measure of severity of autism. Primary analysis included multivariable linear regression models to examine the predictive influence of sociodemographic and sociocultural factors on the dependant variables of age of concern (AOC) and the autism traits (SA, RRB, and CSS). RESULTS The mean AOC in the sample was 18.18 months and the most common concerns were speech/language delay, limited social interaction, and hyperactivity/behavioural changes. The multivariable linear regression models showed factors such as increase in age of child, those from a CALD background, annual family income, sibling's autism diagnosis, and developmental concerns to be significantly associated with parental AOC. Additionally, we also found that increase in child's age and CALD status to be significant predictors of autism trait (RRB) and severity measured in terms of the CSS score. Further, females (compared to males) were associated with higher difficulties with social communication and interaction skills. CONCLUSION Understanding key factors that contribute to early identification of autism can help tailor awareness programs for parents and caregivers, whilst also informing the development of services focused on serving all CALD communities.
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Affiliation(s)
- Aniqa Hussain
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - James Rufus John
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Cheryl Dissanayake
- School of Psychology and Public Health, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Grace Frost
- Autism Specific Early Learning and Care Centre, Prospect, South Australia, Australia
| | - Sonya Girdler
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Cooperative Research Centre for Living with Autism, Brisbane, Australia
| | - Lisa Karlov
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Anne Masi
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Tasha Alach
- Director of Therapy and Clinical Services, Autism Association of Western Australia Inc, Subiaco, WA, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Liverpool Hospital, Sydney, NSW, Australia.
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Bonakdar Tehrani M, Baird K, Trajkovski S, Kemp L. Having to manage: culturally and linguistically diverse mothers' lived experiences with sustained nurse home visiting programs. BMC Health Serv Res 2023; 23:354. [PMID: 37041620 PMCID: PMC10091528 DOI: 10.1186/s12913-023-09315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/21/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Culturally and linguistically diverse (CALD) mothers with young children with limited English proficiency (LEP) encounter multiple barriers in accessing and engaging with primary healthcare services. The aim of this study was to explore the lived experiences and perceptions of CALD mothers with LEP in receiving child and family health nursing (CFHN) services and sustained nurse home visiting (SNHV) programs. METHODS Fourteen mothers were interviewed from two large Local Health Districts in Sydney. All interviews were audio-recorded for transcription purposes. Interpretative Phenomenology Analysis (IPA) was used for analysis and the socioecological approach was applied to interpret the data. RESULTS CALD mothers with LEP experienced both challenges and facilitators in their access and engagement with CFHN services and SNHV programs that were identified in four themes: managing culture; managing the service system; managing the relationship; and strengths and weaknesses of CFHN services. CONCLUSION The integration of strategies such as building trusting relationships, using female professional interpreters and better understanding of CALD mothers' cultural practices may address CALD mothers' needs and facilitate communication. Design and development of model of support involving CALD mothers with LEP in ways that voice their ideas could meet their needs and contribute to better engagement of this vulnerable population with CFHN services and SNHV programs.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia.
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Suza Trajkovski
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), Ingham Institute for Applied Medical Research, Level 3, 1 Campbell Street, Liverpool, NSW, 2170, Australia
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Eapen V, Winata T, Gilbert M, Nair R, Khan F, Lucien A, Islam R, Masi A, Lam-Cassettari C, Mendoza Diaz A, Dissanayake C, Karlov L, Descallar J, Eastwood J, Hasan I, Jalaludin B, Kohlhoff J, Liaw ST, Lingam R, Ong N, Tam CWM, Woolfenden S, Barbaro J. Parental experience of an early developmental surveillance programme for autism within Australian general practice: a qualitative study. BMJ Open 2022; 12:e064375. [PMID: 36442896 PMCID: PMC9710335 DOI: 10.1136/bmjopen-2022-064375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Implementing support and services early in the life course has been shown to promote positive developmental outcomes for children at high likelihood of developmental conditions including autism. This study examined parents'/caregivers' experiences and perceptions about a digital developmental surveillance pathway for autism, the autism surveillance pathway (ASP), and usual care, the surveillance as usual (SaU) pathway, in the primary healthcare general practice setting. DESIGN This qualitative study involves using a convenience selection process of the full sample of parents/caregivers that participated in the main programme, 'General Practice Surveillance for Autism', a cluster-randomised controlled trial study. All interviews were audio-recorded, transcribed and coded using NVivo V.12 software. An inductive thematic interpretive approach was adopted and data were analysed thematically. PARTICIPANTS Twelve parents/caregivers of children with or without a developmental condition/autism (who participated in the main programme) in South Western Sydney and Melbourne were interviewed. SETTINGS All interviews were completed over the phone. RESULTS There were seven major themes and 20 subthemes that included positive experiences, such as pre-existing patient-doctor relationships and their perceptions on the importance of knowing and accessing early support/services. Barriers or challenges experienced while using the SaU pathway included long waiting periods, poor communication and lack of action plans, complexity associated with navigating the healthcare system and lack of understanding by general practitioners (GPs). Common suggestions for improvement included greater awareness/education for parents/carers and the availability of accessible resources on child development for parents/caregivers. CONCLUSION The findings support the use of digital screening tools for developmental surveillance, including for autism, using opportunistic contacts in the general practice setting. TRIAL REGISTRATION NUMBER ANZCTR (ACTRN12619001200178).
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Affiliation(s)
- Valsamma Eapen
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Teresa Winata
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Feroza Khan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Abbie Lucien
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Raisa Islam
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Anne Masi
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christa Lam-Cassettari
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Antonio Mendoza Diaz
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), The University of Queensland, Saint Lucia, Queensland, Australia
| | - Lisa Karlov
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Joseph Descallar
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Faculty of Medicine and Health, School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Iqbal Hasan
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Centre for Research, Evidence Management and Surveillance, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Jane Kohlhoff
- Faculty of Medicine, Discipline of Psychiatry and Mental Health, UNSW, Sydney, New South Wales, Australia
| | - Siaw-Teng Liaw
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, UNSW, Sydney, New South Wales, Australia
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Cooperative Research Centre for Living with Autism, The University of Queensland, Saint Lucia, Queensland, Australia
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10
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Hodgins M, Ostojic K, Hu N, Lawson KD, Samir N, Webster A, Rogers H, Henry A, Murphy E, Lingam R, Raman S, Mendoza Diaz A, Dadich A, Eapen V, Rimes T, Woolfenden S. Study protocol for a real-world evaluation of an integrated child and family health hub for migrant and refugee women. BMJ Open 2022; 12:e061002. [PMID: 36041760 PMCID: PMC10439340 DOI: 10.1136/bmjopen-2022-061002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Continuity of child and family healthcare is vital for optimal child health and development for developmentally vulnerable children. Migrant and refugee communities are often at-risk of poor health outcomes, facing barriers to health service attendance including cultural, language, limited health literacy, discrimination and unmet psychosocial needs. 'Integrated health-social care hubs' are physical hubs where health and social services are co-located, with shared referral pathways and care navigation. AIM Our study will evaluate the impact, implementation and cost-benefit of the First 2000 Days Care Connect (FDCC) integrated hub model for pregnant migrant and refugee women and their infants. MATERIALS AND METHODS This study has three components. Component 1 is a non-randomised controlled trial to compare the FDCC model of care with usual care. This trial will allocate eligible women to intervention and control groups based on their proximity to the Hub sites. Outcome measures include: the proportion of children attending child and family health (CFH) nurse services and completing their CFH checks to 12 months of age; improved surveillance of growth and development in children up to 12 months, post partum; improved breastfeeding rates; reduced emergency department presentations; and improved maternal well-being. These will be measured using linked medical record data and surveys. Component 2 will involve a mixed-method implementation evaluation to clarify how and why FDCC was implemented within the sites to inform future roll-out. Component 3 is a within-trial economic evaluation from a healthcare perspective to assess the cost-effectiveness of the Hubs relative to usual care and the implementation costs if Hubs were scaled and replicated. ETHICS AND DISSEMINATION Ethical approval was granted by the South Eastern Sydney Local Health District Human Research Ethics Committee in July 2021 (Project ID: 020/ETH03295). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001088831.
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Affiliation(s)
| | | | - Nan Hu
- UNSW, Sydney, New South Wales, Australia
| | - K D Lawson
- Western Sydney University, Sydney, New South Wales, Australia
| | - Nora Samir
- UNSW, Sydney, New South Wales, Australia
| | - Amanda Webster
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Helen Rogers
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Elisabeth Murphy
- UNSW, Sydney, New South Wales, Australia
- North Sydney Local Health District, Sydney, New South Wales, Australia
| | - Raghu Lingam
- UNSW, Sydney, New South Wales, Australia
- Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Shanti Raman
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | | | - Ann Dadich
- Western Sydney University, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- UNSW, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Tania Rimes
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- UNSW, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
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11
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Bonakdar Tehrani M, Kemp L, Baird K. Culturally and linguistically diverse mothers accessing public health nursing: A narrative review. Public Health Nurs 2021; 39:82-88. [PMID: 34811798 DOI: 10.1111/phn.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/01/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Culturally and linguistically diverse (CALD) families with young children are less likely to seek out healthcare services in comparison with the mainstream population. A lack of appropriate access and engagement with public health nursing (PHN) service contributes to major health disparities for CALD mothers. AIM To describe and synthesize the available literature on the factors that promote or hinder CALD mothers' access to and engagement with PHN services and in particular sustained nurse home-visiting (SNHV) programs. This paper identifies gaps and new areas of needed research inquiry to support best provision of PHN for CALD mothers. METHOD A narrative review of the literature was conducted. Databases searched included PubMed, CINAHL, MEDLINE, Cochrane, and Scopus with year of publication between 2000 and 2020. RESULTS Of 463 total articles, 12 met inclusion criteria. The key barriers and facilitators identified were grouped in three major themes. These include mother-related issues, experiences with interpreters, and program and program delivery related issues. DISCUSSION The review demonstrates that CALD mothers with limited English proficiency (LEP) are experiencing multiple challenges in accessing and engaging with PHN and SNHV services. More research is needed to understand nurse-mother-interpreter relationships and policy and practice issues.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Liverpool, New South Wales, Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Liverpool, New South Wales, Australia
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Liverpool, New South Wales, Australia
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12
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Bonakdar Tehrani M, Kemp L, Baird K. Sustained nurse home-visiting with culturally and linguistically diverse families: Australian nurses' perspectives. Public Health Nurs 2021; 39:40-47. [PMID: 34687070 DOI: 10.1111/phn.12996] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Australia, sustained nurse home-visiting (SNHV) programs are designed and implemented to promote positive outcomes for mothers with young children experiencing complex life challenges. Despite the crucial role of trained public health nurses, there is a dearth of research about their experiences delivering these programs to culturally and linguistically diverse (CALD) families with limited English proficiency (LEP). AIM This study aimed to explore the experiences of public health nurses in providing services to CALD families with LEP. METHOD Two focus groups were conducted with 13 public health nurses in two major local health districts in Sydney. The focus groups were audio recorded for transcription purposes, and thematically analyzed. A socioecological framework was applied during the analysis process. RESULT Five major themes were identified: (1) program issues; (2) service system issues in understanding and responding to diverse women; (3) issues working with interpreters; (4) trusting relationships; and (5) mother-related facilitators. DISCUSSION To achieve better access and engagement for CALD families, it is crucial that public health nurses increase their knowledge and awareness about potential challenges, such as female interpreter availability, and facilitators, such as engaging the broader family, in order to effectively deliver healthcare services to diverse populations.
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Affiliation(s)
- Mehrnoush Bonakdar Tehrani
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Lynn Kemp
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Kelly Baird
- Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
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13
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Barbaro J, Masi A, Gilbert M, Nair R, Abdullahi I, Descallar J, Dissanayake C, Eastwood J, Hasan I, Jalaludin B, Karlov L, Khan F, Kohlhoff J, Liaw ST, Lingam R, Mendoza Diaz A, Ong N, Tam CWM, Unwin K, Woolfenden S, Eapen V. A Multistate Trial of an Early Surveillance Program for Autism Within General Practices in Australia. Front Pediatr 2021; 9:640359. [PMID: 33968847 PMCID: PMC8102783 DOI: 10.3389/fped.2021.640359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The early detection of developmental conditions such as autism is vital to ensure children can access appropriate and timely evidence-based supports, services, and interventions. Children who have undetected developmental conditions early in life are more likely to develop later health, developmental, learning, and behavioral issues, which in turn can have a cumulative effect over the life course. Methods: The current protocol describes a multi-site, cluster randomized control trial comparing a developmental surveillance pathway for autism to usual care, using opportunistic visits to general practitioners (GPs). Units of randomization are GP clinics across two Australian states (New South Wales and Victoria), with thirty clinics within each state, each of which will aim to recruit approximately forty children aged between ~18- and 24-months, for a total of ~2,400 participants. Children will be randomized to two clusters; namely, an autism surveillance pathway (ASP) or surveillance as usual (SaU). The screening process for the ASP arm involves primary and secondary screenings for developmental concerns for autism, using both parent and GP reports and observations. Children in both arms who show signs of developmental concerns for autism will be offered a full developmental assessment by the research team at 24 months of age to determine the efficacy of developmental surveillance in successfully identifying children with autism. Trial Registration: The trial is registered with ANZCTR (ACTRN12619001200178) and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia.,Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - Anne Masi
- Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Melissa Gilbert
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Radhika Nair
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Ifrah Abdullahi
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia.,Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Faculty of Medicine and Health, School of Medicine, University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine, School of Women and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Iqbal Hasan
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Lisa Karlov
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Feroza Khan
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jane Kohlhoff
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - S T Liaw
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Antonio Mendoza Diaz
- Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Natalie Ong
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Chun Wah Michael Tam
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia.,Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Katy Unwin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Bundoora, VIC, Australia
| | - Sue Woolfenden
- Population Child Health Research Group, Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- Cooperative Research Centre for Living With Autism (Autism CRC), The University of Queensland, Indooroopilly, QLD, Australia.,Faculty of Medicine, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,Academic Unit of Psychiatry, Infant Child and Adolescent Mental Health Services, South Western Sydney Local Health District, Sydney, NSW, Australia
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14
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Ayer C, Eapen V, Overs B, Descallar J, Jalaludin B, Eastwood JG, Dissanayake C, Williams K, Murphy E, Woolfenden S. Risk factors for non-participation in a universal developmental surveillance program in a population in Australia. AUST HEALTH REV 2020; 44:512-520. [PMID: 32731919 DOI: 10.1071/ah18236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/09/2019] [Indexed: 11/23/2022]
Abstract
Objectives This study examined the risk factors for non-participation in a developmental surveillance program in a population in south-west Sydney with a high proportion of culturally diverse and socioeconomically disadvantaged people. Methods Data from 850 and 625 12- and 18-month-old children respectively from the Watch Me Grow (WMG) birth cohort were used for this study. Logistic regression models were used to assess risk factors for 12- and 18-month non-attendance at Well Child Visits, as well as non-completion of the developmental surveillance questionnaire Parents' Evaluation of Developmental Status (PEDS) in the child's personal health record (PHR). Results Independent risk factors for non-attendance at Well Child Visits were female sex of the child (odds ratio (OR) 12 months 1.5; 95% confidence interval (CI) 1.0-2.3), mother's country of birth Australia (OR 18 months 1.8; 95% CI 1.2-2.7), annual household income less than A$25001 (OR 12 months 1.8; 95% CI 1.0-3.2) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 1.7; 95% CI 1.1-2.5). Independent risk factors for non-completion of PEDS in those who did not attend the Well Child Visit compared with those who did attend and did complete PEDS were household annual income at birth less than A$25001 (OR 12 months 3.9; 95% CI 1.9-8.1) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 2.1 (95% CI 1.2-3.7) and OR 18 months 2.0 (95% CI 1.2-3.6)). Conclusions In this population, children exposed to socioeconomic disadvantage are less likely to have attended a Well Child Visit and to have a completed PEDS in their PHR at 12 and/or 18 months of age. What is known about the topic? Developmental problems are common in early childhood, and children from socioeconomically disadvantaged households are at higher risk. Universal developmental surveillance programs may be effective at early identification of children at risk of developmental problems. Early childhood interventions, when accessed, can lessen the effects of developmental problems in later years. What does this paper add? This paper highlights that children exposed to socioeconomic disadvantage in early childhood who are at higher risk of having developmental problems are also at higher risk of missing out on early identification by non-participation in universal developmental surveillance. What are the implications for practitioners? A more equitable model of developmental surveillance should include a framework of proportionate universalism to ensure optimal engagement of high-risk population groups.
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Affiliation(s)
- Chandra Ayer
- Royal Far West, PO Box 52, Manly, NSW 1655, Australia; and Kogarah Diagnostic Assessment Service, St George Hospital, 90 Railway Parade, Kogarah, NSW 2217, Australia; and Corresponding author.
| | - Valsamma Eapen
- Psychiatry Research and Teaching Unit, School of Psychiatry, UNSW, Level 1, Mental Health Centre, Liverpool Hospital, corner Forbes and Campbell Streets, Liverpool, NSW 2170, Australia. ; and Academic Unit of Child Psychiatry, Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia; and South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia
| | | | - Joseph Descallar
- South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia; and Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ;
| | - Bin Jalaludin
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia
| | - John Graeme Eastwood
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and Community Paediatrics, Sydney Local Health District, Level 11 KGV Building, Missenden Road, Camperdown, NSW 2050, Australia. ; and School of Public Health, Menzies Centre for Health Policy, University of Sydney, Edward Ford Building, A27 Fisher Road, Sydney, NSW 2006, Australia; and School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast, Qld 4222, Australia; and School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3083, Australia.
| | - Katrina Williams
- Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Vic. 3010, Australia; and Present address: Department of Paediatrics, Monash University, School of Clinical Sciences, Level 5, Monash Children's Hospital, 246 Clayton Road, Clayton, Vic. 3168, Australia.
| | - Elisabeth Murphy
- NSW Ministry of Health, Child, Youth and Family Health Services, PO Box 4007, Royal North Shore LPO, St Leonards, NSW 2065, Australia.
| | - Susan Woolfenden
- School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia; and Department of Community Paediatrics, Sydney Children's Hospital Network, High Street, Randwick, NSW 2031, Australia.
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15
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Scherr CL, Getachew-Smith HJ, Sudec L, Brooks JJ, Roberts M. Parents' sensemaking processes in the identification of developmental delays and engagement with early intervention services. Soc Sci Med 2020; 255:112941. [PMID: 32402844 DOI: 10.1016/j.socscimed.2020.112941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/22/2020] [Accepted: 03/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Courtney L Scherr
- Department of Communication Studies, Frances Searle Building, 2240 Campus Drive, Evanston, IL, 60208, USA.
| | - Hannah J Getachew-Smith
- Department of Communication Studies, Frances Searle Building, 2240 Campus Drive, Evanston, IL, 60208, USA
| | - Laura Sudec
- The Richard and Roxelyn Pepper Department of Communication Sciences and Disorders, Frances Searle Building, 2240 Campus Drive, Evanston, IL, 60208, USA
| | - John J Brooks
- Department of Communication Studies, Frances Searle Building, 2240 Campus Drive, Evanston, IL, 60208, USA
| | - Megan Roberts
- The Richard and Roxelyn Pepper Department of Communication Sciences and Disorders, Frances Searle Building, 2240 Campus Drive, Evanston, IL, 60208, USA
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16
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Baker J, Kohlhoff J, Onobrakpor SI, Woolfenden S, Smith R, Knebel C, Eapen V. The Acceptability and Effectiveness of Web-Based Developmental Surveillance Programs: Rapid Review. JMIR Mhealth Uhealth 2020; 8:e16085. [PMID: 32324149 PMCID: PMC7206511 DOI: 10.2196/16085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/05/2020] [Accepted: 02/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Web-based developmental surveillance programs may be an innovative solution to improving the early detection of childhood developmental difficulties, especially within disadvantaged populations. Objective This review aimed to identify the acceptability and effectiveness of web-based developmental surveillance programs for children aged 0 to 6 years. Methods A total of 6 databases and gray literature were searched using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses–informed protocol. Data extraction included variables related to health equity. Results In total, 20 studies were identified. Most papers implemented web-based versions of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up screener for autism spectrum disorder or Parent Evaluation of Developmental Status screeners for broad developmental delay. Caregivers and practitioners indicated a preference for web-based screeners, primarily for user-friendliness, improved follow-up accuracy, time, and training efficiencies. Conclusions Although evidence is limited as to the necessity of web- versus face-to-face–based developmental screening, there are clear efficiencies in its use. Trial Registration PROSPERO CRD42019127894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=127894
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Affiliation(s)
- Jess Baker
- The University of New South Wales, Liverpool, Australia
| | - Jane Kohlhoff
- The University of New South Wales, Carramarr, Australia
| | | | | | - Rebecca Smith
- South Eastern Sydney Local Health District, Sydney, Australia
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17
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"Improving Access to Early Childhood Developmental Surveillance for Children from Culturally and Linguistically Diverse (CALD) Background". Int J Integr Care 2020; 20:3. [PMID: 32346361 PMCID: PMC7181950 DOI: 10.5334/ijic.4696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Developmental vulnerabilities in pre-school aged children from culturally and linguistically diverse (CALD) backgrounds with low English proficiency are less likely to be identified through universal developmental surveillance. Barriers include low parental health literacy and low rates of attendance to mainstream child and family health services. Late detection of developmental vulnerabilities can have lifelong impacts on life trajectory. Method: Integrated outreach early childhood developmental surveillance was trialled in South East Sydney by local health services with non-government organisations (NGO) delivering early childhood education and support. NGO staff were trained in Parents Evaluation of Developmental Status (PEDS), a validated developmental screening tool to explore parental/carer and provider concerns [1]. Families with children identified with developmental concerns by NGO staff were referred to co-located or visiting Child and Family Health Nurses (CFHN), community child health, speech pathology or developmental services for developmental screening, assessment and/or care planning. Results: Integrated health and NGO services improved access to developmental surveillance for CALD families in a non-threatening environment enabled by co-locating CFHN, or through visits by paediatric medical/speech pathology staff to participating playgroups. Conclusions and discussion: Integration supported vulnerable families from CALD backgrounds to access developmental surveillance through child and family health services but required flexibility and adjustments by all involved.
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18
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Yao D, Zeng Y, Gao M, Shen J, Zhan J, Zhao Z. A Research on Developmental Characteristics of Children With Language Delay in Zhejiang Province, China. Front Pediatr 2020; 8:479. [PMID: 32984202 PMCID: PMC7477114 DOI: 10.3389/fped.2020.00479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/09/2020] [Indexed: 11/13/2022] Open
Abstract
Study Design: We used Sign-significant relations (S-S) to assess the developmental characteristics of 1- to 4-year-old children with language delays in Zhejiang Province and to provide scientific basis for early clinical detection and comprehensive intervention. Methods: A total of 1,113 children among the ages of 1 and 4 who complained of poor language skills were assessed in language competence using S-S. These children diagnosed with language delays were divided into six groups, with each group having an age difference of 6 months. The developmental characteristics of each group were described and analyzed. Results: (1) Children from the age of 18 to 36 months were most likely to be affected by language problems, while boys were more susceptible than girls in each group. (2) There was no significant difference in the proportion of children with poor communication attitude among the groups. (3) The older the group, the higher the proportion of basic learning ability abnormality. The cutoff age for qualitative leap in the proportion of basic learning abilities was 2 years old. (4) With the increase of age, the proportion of abnormal language comprehension in each group increased gradually. The cutoff age for qualitative leap in the proportion of language comprehension was 1.5 and 2 years old. Conclusion: Language delays usually occur in children around the age of two, and as the children get older, in addition to expression of language abilities, they are more likely to have abnormal language comprehensive abilities and abnormal basic learning abilities. Based on the clinical research, we must take seriously the early screenings for this age group and conduct intervention training as soon as possible.
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Affiliation(s)
- Dan Yao
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Yan Zeng
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Minjie Gao
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Jiyang Shen
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianying Zhan
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhengyan Zhao
- Department of Pediatric Health Care, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,National Clinical Research Center for Child Health, Hangzhou, China
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19
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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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20
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Cuomo B, Joosten A, Vaz S. Scoping review on noticing concerns in child development: a missing piece in the early intervention puzzle. Disabil Rehabil 2019; 43:2663-2672. [PMID: 31885294 DOI: 10.1080/09638288.2019.1707296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Between 13 and 32% of children in developed nations are at-risk for developmental delays. In order to identify concerns, there is a need to understand the mechanisms that facilitate becoming aware of it. AIM A scoping review was conducted to understand this process of "noticing", through existing literature on parent experiences. METHODS Records from major academic databases and grey literature sources were searched using key terms. Thematic analysis was then conducted to synthesise findings. RESULTS Twenty papers meeting inclusion were identified. Noticing a delay was found to be an interplay between who notices - parents or other - and how they do so. How concerns are noticed was through two mechanisms: knowledge of child development, and comparison with other children. CONCLUSIONS This review highlights the nuanced complexity of noticing concerns with a child's development. Understanding how this process occurs and the key ingredients that enable it is vital to supporting early detection of developmental delays.Implications for rehabilitationNoticing developmental delays is a complex process that evolves over time, derived of 'who' notices and 'how' this occurs.When asking parents about child development, professionals need to listen for both bolder "aha moments" as well as more subtle "niggling" comments as indicators of parental concerns.Building baseline parental knowledge of developmental milestones may facilitate noticing of atypical development.Encouraging parents to engage in social opportunities with other children promotes both positive child development and enables developmental monitoring through use of comparison.
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Affiliation(s)
- Belinda Cuomo
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,CoLab (the Minderoo Foundation), Telethon Kids Institute, Perth, Western Australia, Australia
| | - Annette Joosten
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Sharmila Vaz
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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21
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Martinez M, Thomas KC, Williams CS, Christian R, Crais E, Pretzel R, Hooper SR. Family Experiences with the Diagnosis of Autism Spectrum Disorder: System Barriers and Facilitators of Efficient Diagnosis. J Autism Dev Disord 2019; 48:2368-2378. [PMID: 29453706 DOI: 10.1007/s10803-018-3493-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper examines family experiences with the efficiency of ASD diagnosis. Children were age 8 or younger with ASD (n = 450). Outcomes were delay from first parent concern to diagnosis, shifting diagnoses, and being told child did not have ASD. Predictors were screening, travel distance, and problems finding providers. Logit models were used to examine associations. Screening was associated with reduced delay in diagnosis; problems finding providers were associated with greater delay. Screening, travel distance, and delay in diagnosis were associated with shifting diagnoses and being told child did not have ASD. Physician and parent training in communication and addressing mental health professional shortages and maldistribution may improve the diagnosis experiences of families of children with ASD.
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Affiliation(s)
- M Martinez
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA
| | - K C Thomas
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA.
| | - C S Williams
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd, Chapel Hill, NC, 27599-7590, USA
| | - R Christian
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Ct, Carrboro, NC, 27510, USA
| | - E Crais
- Department of Allied Health Sciences, 321 S. Columbia Street, Bondurant Hall, CB#7190, Chapel Hill, NC, 27599-7190, USA
| | - R Pretzel
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Renee Lynne Ct, Carrboro, NC, 27510, USA
| | - S R Hooper
- Department of Allied Health Sciences, 321 S. Columbia Street, Bondurant Hall, CB#7190, Chapel Hill, NC, 27599-7190, USA
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22
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Garg P, Ha MT, Eastwood J, Harvey S, Woolfenden S, Murphy E, Dissanayake C, Williams K, Jalaludin B, McKenzie A, Einfeld S, Silove N, Short K, Eapen V. Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia. BMC FAMILY PRACTICE 2018; 19:42. [PMID: 29609547 PMCID: PMC5879732 DOI: 10.1186/s12875-018-0728-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/19/2018] [Indexed: 11/13/2022]
Abstract
Background Encouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents’ Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort “Watch Me grow” study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program. This paper reports on a qualitative component of the study examining the attitudes, enablers and barriers to the current developmental surveillance practices, with reference to screening tools, amongst health professionals. Methods Qualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed. Results The major themes that emerged from the data were the “difficulties/problems” and “positives/benefits” of surveillance in general, and “specificity” of the tools which were employed. Barriers of time, tool awareness, knowledge and access of referral pathways, and services were important for the physician providers, while the choice of screening tools and access to these tools in other languages were raised as important issues by Child and Family Health Nurses (CFHN). The use of these tools by health professionals was also influenced by what the professionals perceived as the parents’ understanding of their child’s development. While the PEDS and ASQs was utilised by CFHNs, both General Practitioners (GPs) and paediatricians commented that they lacked awareness of developmental screening tools and highlighted further training needs. Conclusions The results highlight the practical challenges to, and limited knowledge and uptake of, the use of recommended screening tools as part of developmental surveillance. There is a need for further research regarding the most effective integrated models of care which will allow for a better collaboration between parents and service providers and improve information sharing between different professionals such as CFHNs GPs, Practices nurses and Paediatricians involved in screening and surveillance programs.
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Affiliation(s)
- Pankaj Garg
- Department of Community Paediatrics, Liverpool Hospital, Liverpool, NSW, Australia.,School of Women's and Children's Health, UNSW, Sydney, Australia.,School of Medicine, University of Sydney, Sydney, Australia.,Specialist Disability Health Team, Fairfield, Australia.,Ingham Institute of Applied Medicine, Liverpool, Australia
| | - My Trinh Ha
- ICAMHS, South Western Sydney Local Health District, Sydney, NSW, Australia.,University of Western Sydney, Sydney, Australia
| | - John Eastwood
- School of Women's and Children's Health, UNSW, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia.,Ingham Institute of Applied Medicine, Liverpool, NSW, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia.,Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, Sydney, Australia
| | - Susan Harvey
- School of Nursing and Midwifery, Griffiths University, Brisbane, QLD, Australia
| | - Sue Woolfenden
- Sydney Children's Hospital Network (Randwick), Randwick, Australia.,UNSW, Sydney, Australia
| | | | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Katrina Williams
- Royal Children's Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Bin Jalaludin
- NSW Ministry of Health, Sydney, Australia.,South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Anne McKenzie
- Child and Family Health Nursing, Primary and Community Health, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy and Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Natalie Silove
- The Children's Hospital at Westmead, Westmead, NSW, Australia.,University of Sydney, Sydney, Australia
| | - Kate Short
- University of Sydney, Sydney, Australia.,Liverpool Hospital, South Western Sydney LHD, Liverpool, NSW, Australia
| | - Valsamma Eapen
- School of Medicine, Griffith University, Gold Coast, QLD, Australia. .,UNSW, ICAMHS, South Western Sydney LHD, Sydney, NSW, Australia. .,Chair, Infant Child and Adolescent Psychiatry, University of New South Wales, Head, Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, L1, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, NSW, 2170, Australia.
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23
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Frakking TT, Waugh J, Teoh HJ, Shelton D, Moloney S, Ward D, David M, Barber M, Carter H, Mickan S, Weir K. Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition: a multi-centre randomised controlled trial study protocol. BMC Pediatr 2018; 18:72. [PMID: 29458335 PMCID: PMC5817718 DOI: 10.1186/s12887-018-1034-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden. A community based service-integration approach, rather than self-directed care is proposed as increased service linkages are more likely to occur and improve the health outcomes of children with a chronic health condition. Methods An open, unblinded, multi-centre randomised controlled trial in two Australian public hospitals. 112 children (0–16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for management of their chronic health condition: (1) integrated children’s care clinic (ICCC) or (2) self-directed care pathway. All children and caregivers will be interviewed at 1 week, and 3, 6 and 12 month time intervals. Primary outcome measures include the Pediatric Quality of Life (PedQOL) questionnaire, Subjective Units of Distress Scale, Child Behaviour Checklist (CBCL) and Rotter’s Locus of Control Scale. Secondary outcome measures include the total number of medical appointments, school days missed and quantity of services accessed. Our main objectives are to determine if the ICCC results in better health and economics outcomes compared to the self-directed care pathway. Discussion The success of a health systems approach needs to be balanced against clinical, mortality and cost-effectiveness data for long-term sustainability within a publicly funded health system. A clinical pathway that is sustainable, cost-effective, provides efficient evidence-based care and improves the quality of life outcomes for children with chronic health conditions has the potential to reduce waitlist times, improve access to health services, increase consumer satisfaction; and prevent costs associated with poorly managed chronic health conditions into adulthood. This study will be the first to provide clinical and health economics data on an integrated care pathway for the management of chronic health conditions in children. On a broader scale, results from this study will help guide care coordination frameworks for children with chronic health conditions; particularly with the introduction and implementation of a National Disability Insurance Scheme (NDIS) across Australia. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR) ACTRN12617001188325. Registered: 14th August, 2017. Electronic supplementary material The online version of this article (10.1186/s12887-018-1034-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thuy Thanh Frakking
- Research Development Unit, Caboolture Hospital, Queensland Health, McKean St, Caboolture, QLD, 4510, Australia. .,School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.
| | - John Waugh
- School of Clinical Medicine, The University of Queensland, St Lucia, QLD, 4067, Australia.,Department of Paediatrics, Caboolture Hospital, Queensland Health, McKean St, Caboolture, QLD, 4510, Australia
| | - Hsien-Jin Teoh
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Doug Shelton
- Department of Community Child Health, Gold Coast University Hospital, Queensland Health, Southport, QLD, 4215, Australia
| | - Susan Moloney
- Department of Paediatrics, Gold Coast University Hospital, Queensland Health, Southport, QLD, 4215, Australia
| | - Donna Ward
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Michael David
- School of Population Health, The University of Queensland, Herston, QLD, 4006, Australia
| | - Matthew Barber
- Ningi Doctors, 1421-1423 Bribie Island Rd, Ningi, QLD, 4511, Australia.,Brisbane North Primary Healthcare Network, Lutwyche, QLD, 4030, Australia
| | - Hannah Carter
- Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
| | - Sharon Mickan
- School of Allied Health Sciences & Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia.,Clinical Governance, Education & Research, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Kelly Weir
- School of Allied Health Sciences & Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia.,Clinical Governance, Education & Research, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
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24
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Garg P, Ha MT, Eastwood J, Harvey S, Woolfenden S, Murphy E, Dissanayake C, Jalaludin B, Williams K, McKenzie A, Einfeld S, Silove N, Short K, Eapen V. Explaining culturally and linguistically diverse (CALD) parents' access of healthcare services for developmental surveillance and anticipatory guidance: qualitative findings from the 'Watch Me Grow' study. BMC Health Serv Res 2017; 17:228. [PMID: 28330490 PMCID: PMC5361826 DOI: 10.1186/s12913-017-2143-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/08/2017] [Indexed: 11/28/2022] Open
Abstract
Background Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. However, there are few published reports from Australian culturally and linguistically diverse (CALD) communities exploring parents’ experiences for accessing child health surveillance programs. This paper aims to describe and explain parental experiences for accessing developmental surveillance and anticipatory guidance for children. Methods Qualitative data was obtained from 6 focus groups (33 parents) and seven in-depth interviews of CALD parents recruited from an area of relative disadvantage in Sydney. Thematic analysis of data was conducted using an ecological framework. Results An overarching theme of “awareness-beliefs-choices” was found to explain parents’ experiences of accessing primary health care services for children. “Awareness” situated within the meso-and macro-systems explained parents knowledge of where and what primary health services were available to access for their children. Opportunities for families to obtain this information existed at the time of birth in Australian hospitals, but for newly arrived immigrants with young children, community linkages with family and friends, and general practitioner (GPs) were most important. “Beliefs” situated within the microsystems included parents’ understanding of their children’s development, in particular what they considered to be “normal” or “abnormal”. Parental “choices”, situated within meso-systems and chronosystems, related to their choices of service providers, which were based on the proximity, continuity, purpose of visit, language spoken by the provider and past experience of a service. Conclusions CALD parents have diverse experiences with primary health care providers which are influenced by their awareness of available services in the context of their duration of stay in Australia. The role of the general practitioner, with language concordance, suggests the importance of diversity within the primary care health workforce in this region. There is a need for ongoing cultural competence training of health professionals and provisions need to be made to support frequent use of interpreters at general practices in Australia.
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Affiliation(s)
- Pankaj Garg
- Department of Community Paediatrics, Liverpool Hospital, Liverpool, Australia.,School of Women's and Children's Health, UNSW, Liverpool, Australia.,School of Medicine, University of Sydney, Westmead, Australia.,Ingham Institute of Applied Medicine, Liverpool, Australia
| | - My Trinh Ha
- University of Western Sydney, Penrith, NSW, Australia
| | - John Eastwood
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia.,Ingham Institute of Applied Medicine, Liverpool, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia.,Syney Local Health District, Croydon, NSW, Australia
| | - Susan Harvey
- School of Nursing and Midwifery, Griffiths University, Queensland, Australia
| | - Sue Woolfenden
- Sydney Children's Hospital Network (Randwick), UNSW, Sydney, Australia
| | | | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Bin Jalaludin
- South Western Sydney Local Health District and UNSW, Sydney, Australia
| | - Katrina Williams
- Royal Children's Hospital, Melbourne and University of Melbourne, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Anne McKenzie
- Primary and Community Health, Child, Youth and Family, Child and Family Health Nursing, South Western Sydney Local Health District, Sydney, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy and Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Natalie Silove
- The Children's Hospital at Westmead, University of Sydney, Sydney, Australia
| | - Kate Short
- Liverpool Hospital, South Western Sydney LHD, University of Sydney, Sydney, Australia
| | - Valsamma Eapen
- UNSW, South Western Sydney LHD, Ingham Institute of Applied Medicine, Liverpool, Australia. .,Infant Child and Adolescent Psychiatry, Academic Unit of Child Psychiatry, South West Sydney LHD, ICAMHS, Mental Health Centre, University of New South Wales, Liverpool Hospital, L1, Elizabeth Street, Liverpool, NSW, 2170, Sydney, Australia.
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25
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Overs BJ, Woolfenden S, Williams K, Jalaludin B, Axelsson EL, Dissanayake C, Descallar J, Harvey S, Beasley D, Murphy E, Eapen V. Predictors of developmental surveillance completion at six months of age in south western Sydney. Child Care Health Dev 2017; 43:307-315. [PMID: 27910128 PMCID: PMC5396131 DOI: 10.1111/cch.12425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 09/22/2016] [Accepted: 10/09/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND While developmental surveillance programs promote early identification of child developmental problems, evidence has indicated suboptimal uptake. This study aimed to identify predictors of developmental surveillance completion at 6 months postpartum. METHODS Questionnaires were administered to the parents of 510 infants who were born in south western Sydney, Australia over a 22-month period. Attendance for developmental screening and completion of the Parents' Evaluation of Developmental Status (PEDS) at 6 months postpartum were modelled separately using multivariable logistic regression. RESULTS Developmental surveillance attendance was predicted by higher levels of maternal education, annual income and being informed about checks. PEDS completion at 6 months of age was predicted by higher income and being informed, as well as being married, employed, speaking English at home, full-term birth and the professional status of the practitioner completing the check. CONCLUSIONS Barriers to developmental surveillance included low socioeconomic status, linguistic diversity and possible gaps in parental knowledge and professional education. Developmental surveillance rates may be increased by the addition of targeted parental and professional support within current universal frameworks.
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Affiliation(s)
- B. J. Overs
- University of New South WalesSydneyNSWAustralia
| | - S. Woolfenden
- University of New South WalesSydneyNSWAustralia,Sydney Children's Hospitals NetworkSydneyNSWAustralia
| | - K. Williams
- Royal Children's HospitalParkvilleVICAustralia,Murdoch Children's Research InstituteParkvilleVICAustralia,University of MelbourneMelbourneVICAustralia
| | - B. Jalaludin
- University of New South WalesSydneyNSWAustralia,South Western Sydney Local Health DistrictLiverpoolNSWAustralia,Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia
| | - E. L. Axelsson
- Australian National UniversityCanberraACTAustralia,Academic Unit of Child PsychiatrySouth Western Sydney Local Health District LiverpoolNSWAustralia
| | - C. Dissanayake
- Olga Tennison Autism Research CentreLa Trobe UniversityMelbourneVICAustralia
| | - J. Descallar
- Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia,South Western Sydney Clinical SchoolUniversity of New South WalesLiverpoolNSWAustralia
| | - S. Harvey
- University of New South WalesSydneyNSWAustralia
| | - D. Beasley
- Child and Family HealthNew South Wales Ministry of HealthSydneyNSWAustralia
| | - E. Murphy
- Child and Family HealthNew South Wales Ministry of HealthSydneyNSWAustralia
| | - V. Eapen
- University of New South WalesSydneyNSWAustralia,South Western Sydney Local Health DistrictLiverpoolNSWAustralia,Ingham Institute for Applied Medical ResearchLiverpoolNSWAustralia
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Green A, Abbott P, Delaney P, Patradoon-Ho P, Delaney J, Davidson PM, DiGiacomo M. Navigating the journey of Aboriginal childhood disability: a qualitative study of carers' interface with services. BMC Health Serv Res 2016; 16:680. [PMID: 27905923 PMCID: PMC5134075 DOI: 10.1186/s12913-016-1926-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/25/2016] [Indexed: 12/31/2022] Open
Abstract
Background The disadvantage experienced by Aboriginal and Torres Strait Islander children with a disability is well recognized. The long term consequences of failing to address disability on health, education and employment underlies the importance of early intervention. Caregivers experience a disproportionate burden and have challenges accessing services. The aim of this study was to describe the carer journey of accessing support and services. Methods We conducted in-depth semi-structured interviews with nineteen parents and carers of Aboriginal children aged 0–8 years. The children were patients at a child developmental clinic at a metropolitan area Aboriginal health service in Eastern Australia. Interpretive phenomenological analysis was applied to transcribed verbatim accounts. Results Four themes were developed using the ‘journey’ metaphor to describe the carer pathway of accessing support and services at the community, service and policy levels. Themes included 1) the need for increased signage within communities via community education, information and awareness, 2) wrong way signs, roundabouts and roadblocks encountered when accessing services, 3) alternate routes can facilitate the journey, and 4) incompatibility of inflexible bureaucratic road rules and lived realities. Conclusions The challenges of caring for a child with a disability are indisputable and these can be compounded for people experiencing socio-economic disadvantage and marginalisation. Overcoming challenges to service access faced by carers of Aboriginal children with a disability will require investment in community, services and policy to tailor culturally appropriate models of care. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1926-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Green
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Penelope Abbott
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia.
| | - Patricia Delaney
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patrick Patradoon-Ho
- Western Sydney University, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown Road, Blacktown, NSW, 2148, Australia
| | - John Delaney
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patricia Mary Davidson
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, Johns Hopkins University, School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Michelle DiGiacomo
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
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27
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Woolfenden S, Eapen V, Jalaludin B, Hayen A, Kemp L, Dissanyake C, Hendry A, Axelsson E, Overs B, Eastwood J, Črnčec R, McKenzie A, Beasley D, Murphy E, Williams K. Prevalence and factors associated with parental concerns about development detected by the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort. BMJ Open 2016; 6:e012144. [PMID: 27609853 PMCID: PMC5020845 DOI: 10.1136/bmjopen-2016-012144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. DESIGN, PARTICIPANTS A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. PRIMARY AND SECONDARY OUTCOMES Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. RESULTS Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6 months, 27% (95% CI 24 to 30) at 12 months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6 months: 1.6 (95% CI 1.1 to 2.4)), (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6 months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. CONCLUSIONS Children with multiple risk factors are more likely to have parental concerns indicating developmental vulnerability using the PEDS and for these concerns to not be documented.
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Affiliation(s)
- Susan Woolfenden
- Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Epidemiology Group, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Hayen
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lynn Kemp
- School of Nursing and Midwifery, University of Western Sydney, Penrith South DC, New South Wales, Australia
| | - Cheryl Dissanyake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, South Australia, Australia
| | - Alexandra Hendry
- Early Years Research Group, Ingham Institute, Sydney South West Local Health District, Sydney, New South Wales, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Bronwyn Overs
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
| | - John Eastwood
- Community Paediatrics, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rudi Črnčec
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Sydney South West Local Health District, Australia,Sydney, New South Wales, Australia
| | - Deborah Beasley
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Elisabeth Murphy
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, South Australia, Australia
- Developmental Medicine, Royal Children's Hospital, Melbourne, South Australia, Australia
- Murdoch Children's Research Institute, Melbourne, South Australia, Australia
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Woolfenden S, Eapen V, Axelsson E, Hendry A, Jalaludin B, Dissanayake C, Overs B, Descallar J, Eastwood J, Einfeld S, Silove N, Short K, Beasley D, Črnčec R, Murphy E, Williams K. Who is our cohort: recruitment, representativeness, baseline risk and retention in the "Watch Me Grow" study? BMC Pediatr 2016; 16:46. [PMID: 27013220 PMCID: PMC4806415 DOI: 10.1186/s12887-016-0582-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Abstract
Background The “Watch Me Grow” (WMG) study examines the current developmental surveillance system in South West Sydney. This paper describes the establishment of the study birth cohort, including the recruitment processes, representativeness, follow-up and participants’ baseline risk for future developmental risk. Methods Newborn infants and their parents were recruited from two public hospital postnatal wards and through child health nurses during the years 2011–2013. Data was obtained through a detailed participant questionnaire and linked with the participant’s electronic medical record (EMR). Representativeness was determined by Chi-square analyses of the available clinical, psychosocial and sociodemographic EMR data, comparing the WMG participants to eligible non-participants. Reasons for non-participation were also elicited. Participant characteristics were examined in six, 12, and 18-month follow-ups. Results The number of infants recruited totalled 2,025, with 50 % of those approached agreeing to participate. Reasons for parents not participating included: lack of interest, being too busy, having plans to relocate, language barriers, participation in other research projects, and privacy concerns. The WMG cohort was broadly representative of the culturally diverse and socially disadvantaged local population from which it was sampled. Of the original 2025 participants enrolled at birth, participants with PEDS outcome data available at follow-up were: 792 (39 %) at six months, 649 (32 %) at 12 months, and 565 (28 %) at 18 months. Participants with greater psychosocial risk were less likely to have follow-up outcome data. Almost 40 % of infants in the baseline cohort were exposed to at least two risk factors known to be associated with developmental risk. Conclusions The WMG study birth cohort is a valuable resource for health services due to the inclusion of participants from vulnerable populations, despite there being challenges in being able to actively follow-up this population.
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Affiliation(s)
- Susan Woolfenden
- Sydney Children's Hospitals Network, Sydney, Australia. .,University of New South Wales, Sydney, Australia.
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Alexandra Hendry
- Early Years Research Group, Ingham Institute, Sydney South West Local Health District, Sydney, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,Epidemiology Group, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Bronwyn Overs
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,Community Paediatrics, South Western Sydney Local Health District, Sydney, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy, Brain & Mind Research Institute, University of Sydney, Sydney, Australia
| | - Natalie Silove
- Sydney Children's Hospitals Network, Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia
| | - Kate Short
- University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Speech Pathology Unit, Liverpool Hospital, Sydney, Australia
| | | | - Rudi Črnčec
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia
| | | | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Sydney, Australia.,Developmental Medicine, Royal Children's Hospital, Sydney, Australia.,Murdoch Children's Research Institute, Sydney, Australia
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