Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1999 Jun;80(6):507–510. doi: 10.1136/adc.80.6.507

A controlled trial of parent initiated and conventional preschool health surveillance using personal child health records

J Dearlove 1, S Illingworth 1
PMCID: PMC1717953  PMID: 10331997

Abstract

OBJECTIVES—A comparison of parent initiated preschool surveillance, using personal child health records, with the then current system of child health surveillance using child health records.
DESIGN—Prospective, controlled trial with randomisation of five general practices into two groups.
SETTING—Five general practices, a well baby clinic, and an orthoptic clinic at Yeovil District Hospital.
SUBJECTS—538 babies born between 1 April 1992 and 1 November 1994, from within the five general practices.
MAIN OUTCOME MEASURES—The number of screenable abnormalities in the two groups that were missed in the first 3 years of a baby's life.
RESULTS—163 babies from the parent initiated preschool surveillance group and 107 from the conventional group completed the study. Although all the mothers from the parent initiated preschool surveillance group understood the concept of parent initiated surveillance, 117 stated their health visitor had made their appointments. Only 45 mothers made their own appointments. The abnormality rates were: 12 of 163 and eight of 107 at 1 year and nine of 163 and six of 107 at 3 years. No medically important conditions were missed. Most mothers did not want to make their own appointments because it was inconvenient. The system was unpopular with health visitors.
CONCLUSION—Parent initiated preschool surveillance is as safe as the current system. Implementing the idea involved a small change in work practice and a large change conceptually for some of the primary health care team. It was not adopted in east Somerset.



Full Text

The Full Text of this article is available as a PDF (95.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appleton P. L., Böll V., Everett J. M., Kelly A. M., Meredith K. H., Payne T. G. Beyond child development centres: care coordination for children with disabilities. Child Care Health Dev. 1997 Jan;23(1):29–40. doi: 10.1046/j.1365-2214.1997.839839.x. [DOI] [PubMed] [Google Scholar]
  2. Appleton P. L., Minchom P. E. Models of parent partnership and child development centres. Child Care Health Dev. 1991 Jan-Feb;17(1):27–38. doi: 10.1111/j.1365-2214.1991.tb00676.x. [DOI] [PubMed] [Google Scholar]
  3. Bero L. A., Grilli R., Grimshaw J. M., Harvey E., Oxman A. D., Thomson M. A. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ. 1998 Aug 15;317(7156):465–468. doi: 10.1136/bmj.317.7156.465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dearlove J., Kearney D. How good is general practice developmental screening? BMJ. 1990 May 5;300(6733):1177–1180. doi: 10.1136/bmj.300.6733.1177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dolan B., Kitson A. Future imperatives: developing health visiting in response to changing demands. J Clin Nurs. 1997 Jan;6(1):11–16. doi: 10.1111/j.1365-2702.1997.tb00278.x. [DOI] [PubMed] [Google Scholar]
  6. Irigoyen M., Findley S. E. Methodological difficulties in assessing contributions by community-based organizations to improving child health. Arch Pediatr Adolesc Med. 1998 Apr;152(4):318–320. doi: 10.1001/archpedi.152.4.318. [DOI] [PubMed] [Google Scholar]
  7. Kendall J. Fighting back: promoting emancipatory nursing actions. ANS Adv Nurs Sci. 1992 Dec;15(2):1–15. doi: 10.1097/00012272-199212000-00003. [DOI] [PubMed] [Google Scholar]
  8. Kitzman H., Olds D. L., Henderson C. R., Jr, Hanks C., Cole R., Tatelbaum R., McConnochie K. M., Sidora K., Luckey D. W., Shaver D. Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA. 1997 Aug 27;278(8):644–652. [PubMed] [Google Scholar]
  9. Locklin M. P. Telling the world: low income women and their breastfeeding experiences. J Hum Lact. 1995 Dec;11(4):285–291. doi: 10.1177/089033449501100415. [DOI] [PubMed] [Google Scholar]
  10. Morgan M. Z., Evans M. R. Initiatives to improve childhood immunisation uptake: a randomised controlled trial. BMJ. 1998 May 23;316(7144):1569–1570. doi: 10.1136/bmj.316.7144.1570. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Oliver S., Rajan L., Turner H., Oakley A., Entwistle V., Watt I., Sheldon T. A., Rosser J. Informed choice for users of health services: views on ultrasonography leaflets of women in early pregnancy, midwives, and ultrasonographers. BMJ. 1996 Nov 16;313(7067):1251–1253. doi: 10.1136/bmj.313.7067.1251a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Reading R., Allen C. The impact of social inequalities in child health on health visitors' work. J Public Health Med. 1997 Dec;19(4):424–430. doi: 10.1093/oxfordjournals.pubmed.a024672. [DOI] [PubMed] [Google Scholar]
  13. Scott S. Intensive interventions to improve parenting. Arch Dis Child. 1998 Jul;79(1):90–93. doi: 10.1136/adc.79.1.90. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wiemann C. M., DuBois J. C., Berenson A. B. Strategies to promote breast-feeding among adolescent mothers. Arch Pediatr Adolesc Med. 1998 Sep;152(9):862–869. doi: 10.1001/archpedi.152.9.862. [DOI] [PubMed] [Google Scholar]
  15. Williams D. M. Vulnerable families: a study of health visitors' prioritization of their work. J Nurs Manag. 1997 Jan;5(1):19–24. doi: 10.1046/j.1365-2834.1997.02413.x. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES