Related Experiment Videos
Developmental screening: predictors of follow-up adherence in primary health care
Joanné Christine Schoeman1, De Wet Swanepoel1,2,3, Jeannie van der Linde1
1Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Insights
Early intervention follow-up adherence is poor, with only 17% attending appointments. Text message reminders were ineffective, and caregivers often lacked concern about developmental delays, highlighting a need for increased awareness and education.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Public Health
Background:
- Early identification of developmental delays in young children is crucial for effective intervention.
- However, poor follow-up on referrals significantly hinders the success of early intervention programs.
Purpose of the Study:
- To identify factors influencing follow-up adherence for early intervention services after developmental screening in primary care.
- To assess the impact of text message reminders on adherence.
- To investigate reasons for follow-up default among caregivers.
Main Methods:
- A quasi-experimental correlational study involving 247 high-risk children screened using the PEDS tools.
- Risk assessment questionnaires administered to caregivers of children referred for therapy (n=106).
- Thematic analysis of telephonic interviews with caregivers who defaulted on appointments.
Main Results:
- Follow-up adherence was low at 17%.
- Text message reminders did not improve adherence.
- Caregivers who were never married, divorced, or widowed showed higher (though not statistically significant) likelihood of attending appointments compared to married/cohabiting caregivers.
- Primary reasons for default included lack of concern about child development (87%), employment, logistical issues, other responsibilities, and forgetfulness.
Conclusions:
- Follow-up adherence to early intervention services after a positive screen in primary care is critically low.
- There is a significant need for enhanced parental awareness and education regarding the importance of child development for future educational success.
Background:
The importance of early identification for infants and young children with developmental delays is well established. Poor follow-up on referrals, however, undermines the effectiveness of early intervention programmes.
Objectives:
To identify factors, including text message reminders, that influence follow-up adherence for early intervention after developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default.
Methods:
The PEDS tools were used to screen 247 high-risk children. A risk assessment questionnaire was completed with caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental correlational study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews was also employed to determine reasons for follow-up defaults.
Results:
Follow-up adherence was 17%. Participants who were never married, divorced or widowed were 2.88 times more likely to attend a follow-up appointment than those who were married or living together (95%, CI 0.97-8.63). Text message reminders did not improve follow-up. More than half (58%) of participants who defaulted on appontments could be reached for telephonic interviews. Interviews showed that 87% of participants were unconcerned about their child's development. Other reasons for defaulting were employment, logistical issues, other responsibilities and forgetfulness.
Conclusion:
Follow-up adherence for early intervention services following a positive primary health care screen was poor. Increased awareness and education regarding the importance of development for educational success is needed.