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


METHODS
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.


CONCLUSIONS
Some PCH professionals are more likely to identify psychosocial problems than others, independently from parent-reported problems or other risk indicators.
TNO Quality of Life, Prevention and Health Care, Leiden, Zuid Holland, The Netherlands. ton.vogels@tno.nl
Antonius G C
AG
Vogels
Gert W
GW
Jacobusse
Femke
F
Hoekstra
Emily
E
Brugman
Matty
M
Crone
Sijmen A
SA
Reijneveld
D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology; D002662:Child Health Services / Q000592:standards; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015588:Observer Variation; D010290:Parents; D011594:Psychometrics; D012307:Risk Factors; D012737:Sex Factors