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Conducting routine health surveillance checks for two year olds by group assessment
Amy Lee1, Gillian Parker, Diane Townsend
1Brentwood and Wickford Primary Care Trust.
Insights
Group health surveillance for two-year-olds is effective and preferred by parents, offering a viable alternative to one-to-one checks. This method efficiently uses resources while ensuring comprehensive child development assessment.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Routine health surveillance for two-year-old children traditionally uses a one-to-one approach.
- Assessing child development and parental concerns is crucial at this age.
- Optimizing healthcare resource utilization is an ongoing challenge in child health services.
Purpose of the Study:
- To evaluate the effectiveness and parental satisfaction of group-based health surveillance for two-year-olds.
- To compare the group assessment model with the traditional one-to-one approach.
- To determine if group assessments are a suitable alternative for child health and development surveillance.
Main Methods:
- 160 two-year-old children and their parents participated in one-hour group sessions (max 8 children per group).
- Children's play was observed by a nursery nurse and health visitor against the Personal Child Health Record (PCHR) milestones.
- Parents engaged in group discussions on health and safety, followed by individual interviews.
Main Results:
- Overwhelmingly positive parental satisfaction with the group assessment method.
- All parents opted for group assessment when offered a choice; most preferred it over previous one-to-one experiences.
- Parents found group discussions reassuring and helpful for sharing coping strategies; no child required follow-up due to incomplete assessment.
- Group assessments demonstrated more effective use of professional resources.
Conclusions:
- Group assessment is an effective and highly-rated method for routine child health and development surveillance at two years.
- This model provides a viable and efficient alternative to traditional one-to-one surveillance interviews.
- The approach enhances parental engagement and resource management in child health services.
Objective:
To examine whether the routine health surveillance check for two-year-old children could be satisfactorily conducted with children and their parents in groups, rather than by the traditional one-to-one approach.
Method:
Over a period of one year, a total of 160 two-year-old children were seen with their parents at group assessment sessions lasting one hour. The maximum number of two year olds at each session was eight. Children with special needs were excluded. The children's play was supervised and observed by a nursery nurse and health visitor. They recorded when individual children demonstrated activities expected of a two year old as specified in the national parent-held Personal Child Health Record (PCHR). While the children played, another health visitor led a group discussion with the parents on health and safety issues identified by the PCHR as important for two year olds. The parents then had individual interviews with a health visitor to receive feedback about their child's assessment and to discuss any issues in confidence.
Results:
Evaluation showed that the overwhelming number of parents were satisfied with the group assessment method of health surveillance for their two year olds. Although offered a choice of group or traditional one-to-one assessments, all opted for group assessment. Of those with previous experience of the traditional method, most preferred the group assessment. Many parents commented that the group discussion was reassuring in showing them that other parents had similar problems and helpful in enabling them to hear other parents' ways of coping. No child needed a follow-up because part of the assessment had not been completed. The group assessments proved a more effective use of scarce professional resources, freeing staff time for other activities.
Conclusion:
Group assessment for routine child health and development surveillance at the age of two years appears to be effective and received a high approval rating from parents. It offers a viable alternative to the traditional one-to-one surveillance interviews.