title: Determining Childhood Blood Lead Level Screening Compliance Among Physicians.
abstract: Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.
authors.affiliation: Nevada Institute for Children's Research and Policy, University of Nevada, Las Vegas, 4505 Maryland, Parkway, Box 453064, Las Vegas, NV, 89154-3030, USA. amanda.haboush@unlv.edu.
authors.forename: Amanda
authors.identifier: http://orcid.org/0000-0001-8887-3452
authors.initials: A
authors.lastname: Haboush-Deloye
authors.affiliation: Department of Environmental and Occupational Health, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 453064, Las Vegas, NV, 89154-3064, USA.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Marquez
authors.affiliation: School of Community Health Sciences, University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 453064, Las Vegas, NV, 89154-3064, USA.
authors.forename: Shawn L
authors.initials: SL
authors.lastname: Gerstenberger
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D002675:Child, Preschool; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis*; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*; D010290:Parents; D017410:Practice Guidelines as Topic; D014481:United States
chemical_list: D007854:Lead
keywords: Childhood lead poisoning; Health care providers; Physician