Parental and health visitor perceptions on growth screening in early childhood: a qualitative study
Tahmid Rahman1, Joanna Orr2, Joseph Freer2
1Royal Holloway University of London, London, UK.
Insights
Implementing child growth screening is feasible and acceptable for health visitors and parents. Health visitors need resources to refer children for necessary services, ensuring holistic early childhood care.
Area of Science:
- Child Health
- Public Health
- Qualitative Research
Background:
- Early childhood growth screening identifies vulnerabilities.
- The UK's Healthy Child Programme assesses child development up to age 5.
- Referral criteria for growth screening are unclear, lacking qualitative data on feasibility.
Purpose of the Study:
- To understand caregiver and health visitor perceptions of child growth.
- To assess the acceptability and feasibility of formal growth screening programs.
- To explore motivations regarding child growth and screening.
Main Methods:
- Longitudinal observational study involving qualitative focus groups.
- Interviews conducted with health visitors (n=10) and parents (n=6 English-speaking, n=5 Sylheti-speaking).
- Thematic analysis of data, with a bilingual researcher facilitating and translating.
Main Results:
- Parents desire holistic care and easier access to health visitors for advice and referrals.
- Health visitors are perceived as key in educating parents and identifying children needing support.
- Both parents and health visitors emphasized the need for resources to provide services post-assessment.
Conclusions:
- Growth screening via health visitors is feasible and acceptable with adequate resources.
- Empowering health visitors to refer children is crucial for effective screening.
- Implementation requires resources for both assessment and subsequent service provision.
Background:
Growth screening in early childhood can help identify children with a range of medical and psychosocial vulnerabilities. In the UK, childhood growth and development up to age 5 years are assessed through the Healthy Child Programme, delivered by health visitors. However, formal criteria to trigger referrals for onward investigation are unclear. There is a lack of qualitative data on the acceptability and feasibility of formal growth screening programmes. This study aimed to build understanding of the perceptions and motivations of caregivers and health visitors in relation to child growth and growth screening.
Methods:
This longitudinal observational study was part of a larger study piloting an automated growth screening algorithm in Tower Hamlets, London. We conducted three separate qualitative focus group interviews with health visitors (n=10), English-speaking parents (n=6), and Sylheti-speaking parents (n=5). Participants were purposively sampled, and written informed consent was obtained. A bilingual researcher facilitated each group, using a semi-structured interview guide. Data were analysed by two researchers using thematic analysis and assessed for intercoder reliability. The interview guide was translated into Sylheti, and data from the Sylheti group were translated into English by the same bilingual researcher.
Findings:
Findings suggest that parents desire holistic care in which health visitors are empowered to refer to other health professionals and council services. Parents also want easier access to health visitors, frequent visits with the same health-care provider, and advice on raising their children. Health visitors were seen as well positioned to play an essential role in educating parents on health and developmental milestones and in helping them identify when their child might need additional support. Both parents and health visitors stressed that resources need to be in place not only to assess children but also to provide access to services when problems are identified.
Interpretation:
These findings suggest that implementing growth screening through health visitors is feasible and acceptable, provided health visitors are given the resources and capabilities to refer children to appropriate services. Interpretation is limited by the purposive nature of the sampling and possible response bias.
Funding:
Barts Charity.
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