Parents' Adherence to Childhood Screening Tests and Referrals: A Retrospective Cohort Study with Randomized Sampling

Area of Science:

• Pediatrics
• Public Health
• Health Services Research

Background:

• Routine well-child visits are crucial for optimal child health outcomes.
• Evidence suggests suboptimal parental compliance with recommended well-child visit schedules.
• Understanding barriers to adherence is vital for improving child health surveillance.

Purpose of the Study:

• To investigate factors influencing parental nonadherence to routine childhood screening tests.
• To identify factors associated with parents acting on further referrals after abnormal screening findings.
• To inform strategies for enhancing child health monitoring and intervention.

Main Methods:

• Retrospective cohort study of 14,348 children born 2016-2017 in Israel.
• Random sample of 844 children analyzed for screening tests at two and nine months.
• Multiple logistic regression used to identify predictors of nonadherence and referral follow-up.

Main Results:

• Lower adherence observed for nine-month screening tests compared to two-month visits.
• Higher adherence rates for screening tests conducted by nurses versus physicians.
• Risk factors for nonadherence included complex delivery, older maternal age, higher parity, and Israeli citizenship.
• Fewer children in the family and initial physician findings were key drivers for acting on referrals.

Conclusions:

• Targeted public health campaigns are needed to emphasize the importance of screening tests and referrals.
• Addressing parental adherence barriers can improve childhood health outcomes and lifelong well-being.
• Health policymakers should prioritize interventions to ensure comprehensive child health surveillance.