Screening for psychosocial problems in 5-6-year olds: a randomised controlled trial of routine health assessments.
rct · Level II
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Abstract
OBJECTIVE: Children's psychosocial problems are often not identified accurately. The present study addresses the effect of training of Child Health Doctors (CHDs) in a structured method to identify psychosocial problems on the accuracy of this identification in children aged 5-6. METHOD: The study was a randomised controlled trial (RCT) with a baseline and two follow-up measurements. A volunteer sample of 58 CHDs participated, randomly assigned to intervention or control condition. CHDs selected a population-based sample of 5-6-year-old children (n = 6375). RESULTS: The first follow-up showed that sensitivity had improved by 9% and specificity by 5% in the intervention condition, especially in children with severe problems (odds ratio = 3.7; 95% confidence interval: 1.2-11.8). The second follow-up showed a decrease in sensitivity and specificity in both conditions. CONCLUSION: The training improves identification of psychosocial problems, especially severe ones, although the availability of time and resources also influences the accuracy with which psychosocial problems are identified.