title: When do parents and child health professionals agree on child's psychosocial problems? Cross-sectional study on parent-child health professional dyads.
abstract: BACKGROUND
  About one third of all parents have concerns about their child's psychosocial development. Agreement between child health professionals (CHPs) and parents about such concerns may improve treatment adherence and outcomes. This study investigates which child, parenting and/or environmental stressors are associated with (dis)agreement in concerns regarding psychosocial problems in children, in parent-CHP dyads.
  
  
  METHODS
  During routine child health assessments, data were collected from a sample of children aged 14 months to 12 years (n = 3,870). CHPs registered the psychosocial problems that they identified, and parents reported their concerns. Child psychosocial stressors were measured with the ITSEA/CBCL, and the child's history of psychosocial problems. Environmental stressors referred to stressful family/contextual situations in the past year, and parenting stressors to perceived parenting efficacy.
  
  
  RESULTS
  The CHPs and parents disagreed on 36.4 % of the children. CHPs based their identification of problems mainly on children's history of past problem (OR = 5.85, 95% CI = 4.74-7.22). Parental concerns were most likely in case of an increased ITSEA/CBCL score (OR = 7.69, CI = 5.39-10.97). CHP-parent agreement was more likely in case of a combination of child psychosocial, parenting and environmental stressors (OR = 35.58, CI = 24.11-52.48). Parental concerns not confirmed by the CHP were associated with higher educated parents, originating from an industrialized country, and younger children. The CHP-identified problems not confirmed by parental concerns were associated with older children.
  
  
  CONCLUSIONS
  Agreement between CHPs and parents is associated with a co-occurrence of child, parenting and environmental stressors. Improved agreement between CHP and parents will increase the likelihood of shared decision-making regarding follow-up care and compliance with advice.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Public Health and Primary Care, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. m.r.crone@lumc.nl.|TNO, Leiden, The Netherlands. m.r.crone@lumc.nl.
authors.forename: Mathilde R
authors.initials: MR
authors.lastname: Crone
authors.affiliation: Province of Gelderland, Department of Youth Care, P.O. Box 9090, 6800 GX, Arnhem, The Netherlands.
authors.forename: Elke
authors.initials: E
authors.lastname: Zeijl
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.|TNO, Leiden, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D002648:Child; D002657:Child Development; D000067576:Child Health; D002662:Child Health Services; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D009426:Netherlands; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations
keywords: Agreement; Child; Identification; Mental health; Parental concerns; Preschool child; Stressful events; Vulnerability