The added value of a family-centered approach to optimize infants' social-emotional development: A quasi-experimental
Sijmen A Reijneveld1, Margriet Hielkema1, Roy E Stewart1
1Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Insights
Family-centered care (FCC) may improve early identification of social-emotional problems in children. However, this approach did not reduce child psychosocial problems by 18 months.
Area of Science:
- Pediatric Healthcare
- Child Psychology
- Family Support Services
Background:
- Family-centered care (FCC) is linked to positive pediatric outcomes.
- The Netherlands Trial Register study (NTR2681) investigated FCC's impact on social-emotional development.
- Routine well-child care in the Netherlands served as the study setting.
Purpose of the Study:
- To evaluate if family-centered care (FCC) improves early identification of social-emotional problems.
- To assess if FCC reduces child psychosocial problems at 18 months.
- To compare the pace and frequency of social-emotional risk identification between FCC and usual care.
Main Methods:
- A quasi-experimental design compared FCC-JointStart regions with usual care (CAU) regions.
- Professionals conducted well-child visits from 2-18 months, assessing social-emotional risks.
- Child psychosocial wellbeing was measured using the Child Behavior Checklist (CBCL) at 18 months.
Main Results:
- Risks for social-emotional problems were identified more frequently and earlier in the FCC-JointStart group.
- Additional care was provided to more severe cases under FCC.
- No significant differences in Child Behavior Checklist (CBCL) scores were observed between groups at 18 months.
Conclusions:
- Family-centered care (FCC) shows potential for earlier and increased identification of social-emotional risks.
- FCC may facilitate better identification of families requiring additional support.
- FCC did not demonstrate a reduction in child psychosocial problems by 18 months.
Objective:
Family-centered care (FCC) has been related to positive healthcare outcomes in pediatric care. Our aim was to assess whether an FCC approach also leads to better and earlier identification of social-emotional problems and less child psychosocial problems at age 18 months.
Methods:
In a quasi-experimental study within routine well-child care in the Netherlands, we compared those regions in which an FCC approach was implemented (FCC-JointStart) to those regions with "care-as-usual" (CAU), including all children. In all regions, professionals performed well-child visits (2-18 months) and assessed social-emotional problems, or risks developing these, by rating outcomes of assessments as "not optimal" or as "a problem." We compared FCC-JointStart and CAU regarding the rates of newly identified (risks for) social-emotional problems, the pace of identification over time, and the child's psychosocial wellbeing at eighteen months as measured by the Child Behavior Checklist (CBCL). For participants that received extra care, we compared FCC-JointStart and CAU regarding the severity of parent-reported problems. Parents were blinded, professionals were not.
Results:
5658 parents (68%) agreed to participate in the study. In the FCC-JointStart group, risks were identified more frequently, though differences were small (24.7% versus 22.0%, odds ratio (95%-confidence interval) adjusted for confounders: 1.44 (0.96; 2.18), Phi = .03). Risks were also identified earlier (p = .008), and additional care was provided to more severe cases than in CAU. Effect sizes r ranged from 0.17 (PSBC) to 0.22 (FAD). CBCL scores at 18 months did not differ between groups.
Conclusions:
FFC-JointStart may contribute to more and earlier identification of risks for social-emotional problems and of families that need additional care, but not to fewer child psychosocial problems at age 18 months.
Trial Registration:
Netherlands Trial Register NTR2681.
Related Concept Videos
Socioemotional Development during Infancy
Primary Temperament Types
Relationship with Parents: Attachment
Attachment
Socioemotional Experience and Gender Development
Impact of Social Context on Individuals
Relationship with Other Adult Family Members and Siblings


