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Screening for psychosocial problems in 5-6-year olds: a randomised controlled trial of routine health assessments
Carin H Wiefferink1, Sijmen A Reijneveld, Joop de Wijs
1TNO Prevention and Health, P.O. Box 2215, 2301 CE Leiden, The Netherlands. ch.wiefferink@pg.tno.nl
Insights
Training Child Health Doctors (CHDs) improved their accuracy in identifying children's psychosocial problems, particularly severe cases. However, time and resources also impact accurate identification.
Area of Science:
- Pediatric Health
- Child Psychology
- Medical Education
Background:
- Accurate identification of psychosocial problems in children is a significant clinical challenge.
- Existing methods for identifying childhood psychosocial issues often lack sufficient accuracy.
- Child Health Doctors (CHDs) play a crucial role in early detection of these problems.
Purpose of the Study:
- To evaluate the impact of structured training on Child Health Doctors' (CHDs) ability to accurately identify psychosocial problems in 5-6-year-old children.
- To assess the effectiveness of a specific training intervention on diagnostic accuracy for pediatric psychosocial issues.
Main Methods:
- A randomized controlled trial (RCT) design was employed with baseline and two follow-up measurements.
- Fifty-eight volunteer Child Health Doctors (CHDs) were randomly assigned to either an intervention or control group.
- A population-based sample of 6,375 children aged 5-6 years was assessed.
Main Results:
- The intervention group showed a 9% improvement in sensitivity and a 5% improvement in specificity at the first follow-up.
- The training was particularly effective for identifying severe psychosocial problems (odds ratio = 3.7).
- A decrease in both sensitivity and specificity was observed in both groups by the second follow-up.
Conclusions:
- Structured training significantly enhances Child Health Doctors' (CHDs) accuracy in identifying psychosocial problems in young children, especially severe cases.
- The long-term effectiveness of the training may be influenced by factors such as time and resource availability.
- Further research is needed to sustain the benefits of training in real-world clinical settings.
Objective:
Children's psychosocial problems are often not identified accurately. The present study addresses the effect of training of Child Health Doctors (CHDs) in a structured method to identify psychosocial problems on the accuracy of this identification in children aged 5-6.
Method:
The study was a randomised controlled trial (RCT) with a baseline and two follow-up measurements. A volunteer sample of 58 CHDs participated, randomly assigned to intervention or control condition. CHDs selected a population-based sample of 5-6-year-old children (n = 6375).
Results:
The first follow-up showed that sensitivity had improved by 9% and specificity by 5% in the intervention condition, especially in children with severe problems (odds ratio = 3.7; 95% confidence interval: 1.2-11.8). The second follow-up showed a decrease in sensitivity and specificity in both conditions.
Conclusion:
The training improves identification of psychosocial problems, especially severe ones, although the availability of time and resources also influences the accuracy with which psychosocial problems are identified.
