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Routine developmental screening in Australian general practice: a pilot study

BACKGROUND: Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examine...

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Autores principales: Alexander, Karyn, Mazza, Danielle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331965/
https://www.ncbi.nlm.nih.gov/pubmed/37430184
http://dx.doi.org/10.1186/s12875-023-02093-7
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author Alexander, Karyn
Mazza, Danielle
author_facet Alexander, Karyn
Mazza, Danielle
author_sort Alexander, Karyn
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description BACKGROUND: Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations. METHODS: The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners. RESULTS: Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints. CONCLUSIONS: A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-023-02093-7.
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spelling pubmed-103319652023-07-11 Routine developmental screening in Australian general practice: a pilot study Alexander, Karyn Mazza, Danielle BMC Prim Care Research BACKGROUND: Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations. METHODS: The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners. RESULTS: Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints. CONCLUSIONS: A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-023-02093-7. BioMed Central 2023-07-10 /pmc/articles/PMC10331965/ /pubmed/37430184 http://dx.doi.org/10.1186/s12875-023-02093-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Alexander, Karyn
Mazza, Danielle
Routine developmental screening in Australian general practice: a pilot study
title Routine developmental screening in Australian general practice: a pilot study
title_full Routine developmental screening in Australian general practice: a pilot study
title_fullStr Routine developmental screening in Australian general practice: a pilot study
title_full_unstemmed Routine developmental screening in Australian general practice: a pilot study
title_short Routine developmental screening in Australian general practice: a pilot study
title_sort routine developmental screening in australian general practice: a pilot study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331965/
https://www.ncbi.nlm.nih.gov/pubmed/37430184
http://dx.doi.org/10.1186/s12875-023-02093-7
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