Public health and preventive healthcare in children: current practices of Victorian GPs and barriers to participation.
OBJECTIVE
To assess general practitioners' attitudes to and involvement in child public health activities and identify barriers affecting their participation.


METHODS
Cross-sectional written questionnaire survey of a representative sample of actively practising GPs.


METHODS
General practices in the State of Victoria.


METHODS
840 GPs returned questionnaires (65% response rate), and, of these, 792 (94%) saw children 0-12 years.


METHODS
Attitudes to and involvement in public health promotion; predictive factors for GPs' involvement.


RESULTS
The odds of GPs' involvement in child public health issues were increased by being female (odds ratio [OR], 1.88), receiving basic medical qualifications outside Australia (OR, 1.55), attending continuing education and postgraduate training (OR, 1.60), and having confidence in dealing with newborns and infants (OR, 1.93) and preschool children (OR, 2.94) (both P < 0.05). Older GPs, compared with younger GPs, had significantly lower odds of involvement (P < 0.01). After adjustment, GPs had higher odds of involvement if they agreed it was important for them to take part in health promotion, or in screening and surveillance (OR, 2.76 and 1.94, respectively; P < or = 0.05); and lower odds if they agreed that screening and surveillance should be mainly done by maternal and child health nurses (OR, 0.60). The most common barriers to involvement were insufficient time, inadequate financial reimbursement for long consultations, inappropriateness of raising these issues in children presenting with illness, and lack of community resources.


CONCLUSIONS
Increasing GPs' involvement in child public health will require attention to barriers (time, remuneration and perceived appropriateness), continuing education and changes in workforce composition and patterns.
Centre for Community Child Health, University of Melbourne, Royal Children's Hospital, Vic. waterse@cryptic.rch.unimelb.edu.au
E B
EB
Waters
M M
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Haby
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M
Wake
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Salmon
D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services; D014739:Victoria