Identification of children with psychosocial problems differed between preventive child health care professionals

Vogels, Antonius G.C.; Jacobusse, Gert W.; Hoekstra, Femke; Brugman, Emily; Crone, Matty; Reijneveld, Sijmen A.

doi:10.1016/j.jclinepi.2007.12.005

« Previous Next »Journal of Clinical Epidemiology
Volume 61, Issue 11 , Pages 1144-1151, November 2008

Identification of children with psychosocial problems differed between preventive child health care professionals

Antonius G.C. Vogels
- TNO Quality of Life, Prevention and Health Care, PO Box 2215, 2301 CE Leiden, Zuid Holland, The Netherlands
- Corresponding author. Tel.: +31-71-5181658; fax: +31-71-5181920.
Gert W. Jacobusse
- TNO Quality of Life, Prevention and Health Care, PO Box 2215, 2301 CE Leiden, Zuid Holland, The Netherlands
- Tel.: +31-71-5181596; fax: +31-71-5181920.
Femke Hoekstra
- Municipal Health Service Amsterdam, Postbus 2200, 1000 CE Amsterdam, The Netherlands
- Tel.: +31-20-5555789.
Emily Brugman
- University of Amsterdam, Clinical Psychology, Roeterstraat 15, 1018 WB Amsterdam, The Netherlands
- Tel.: +31-20-5256810; fax: +31-20-6391369.
Matty Crone
- TNO Quality of Life, Prevention and Health Care, PO Box 2215, 2301 CE Leiden, Zuid Holland, The Netherlands
- Tel.: +31-71-5181899; fax: +31-71-5181920.
Sijmen A. Reijneveld
- TNO Quality of Life, Prevention and Health Care, PO Box 2215, 2301 CE Leiden, Zuid Holland, The Netherlands
- University Medical Center Groningen, Department of Health Sciences, PO Box 196, University of Groningen, 9700 AD Groningen, The Netherlands
- Tel.: +31-50-3632845; fax: +31-50-3636251.

Accepted 12 December 2007. published online 09 June 2008.

Abstract

Objective

To assess whether differences between individual Preventive Child Health Care (PCH) professionals in the percentage of children they identify as having psychosocial problems are larger than expected based on chance and whether such differences can be explained by differences in parent-reported problems or risk indicators.

Study Design

We used data from three community-based studies among 3,170 Dutch children aged 8 till 12 years, invited for a routine health examination. Parents filled in the Child Behavior Checklist (CBCL) and questions on demographic characteristics. After the examination, PCH professionals registered whether they had identified any psychosocial problem in the child. We examined differences between professionals in the rate of identified children. We used multilevel logistic regression analysis to assess whether such differences could be explained by parent-reported problems or risk indicators.

Results

Significant differences between PCH professionals were found (P<0.001). These differences could not be explained by parent-reported problems or risk indicators. The differences were largest for children with a score above the CBCL clinical cut-off point.

Conclusion

Some PCH professionals are more likely to identify psychosocial problems than others, independently from parent-reported problems or other risk indicators.

Keywords: Assessment, Child mental health, Clinical preventive services, Physician decision making, Psychosocial aspects, Public health