title: Evaluation of a newborn screen for predicting out-of-home placement.
abstract: A newborn screen designed to predict family risk was examined to: (a) determine whether all families with newborns were screened; (b) evaluate its predictive validity for identifying risk of out-of-home placement, as a proxy for maltreatment; (c) determine which items were most predictive of out-of-home placement. All infants born in Manitoba, Canada from 2000 to 2002 were followed until March 31, 2004 (N = 40,886) by linking four population-based data sets: (a) newborn screening data on biological, psychological, and social risks; (b) population registry data on demographics; (c) hospital discharge data on newborn birth records; (d) data on children entering out-of-home care. Of the study population, 18.4% were not screened and 3.0% were placed in out-of-home care at least once during the study period. Infants not screened were twice as likely to enter care compared to those screened (4.9% vs. 2.5%). Infants screening at risk were 15 times more likely to enter care than those screening "not at risk." Sensitivity and specificity of the screen were 77.6% and 83.3%, respectively. Screening efforts to identify vulnerable families missed a substantial portion of families needing support. The screening tool demonstrated moderate predictive validity for identifying children at risk of entering care in the first years of life.
authors: Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada. marni_brownell@cpe.umanitoba.ca
authors: Marni D
authors: MD
authors: Brownell
authors: Mariette
authors: M
authors: Chartier
authors: Robert
authors: R
authors: Santos
authors: Wendy
authors: W
authors: Au
authors: Noralou P
authors: NP
authors: Roos
authors: Darlene
authors: D
authors: Girard
mesh_terms: D001294:Attitude to Health; D002649:Child Abuse / Q000517:prevention & control*; D003415:Crime / Q000517:prevention & control; D005191:Family Characteristics; D005260:Female; D005581:Foster Home Care / Q000706:statistics & numerical data*; D006801:Humans; D007224:Infant Care / Q000458:organization & administration*; D007229:Infant Welfare / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D008350:Manitoba; D008403:Mass Screening / Q000295:instrumentation* / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011632:Public Assistance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity