TY - JOUR
T1 - An innovative postnatal risk assessment and corresponding care pathways in Preventive Child Healthcare
AU - Van Minde, Minke R. C.
AU - Lagendijk, Jacqueline
AU - Raat, Hein
AU - Steegers, Eric A. P.
AU - de Kroon, Marlou L. A.
N1 - Funding Information:
We thank all PCHC organizations who participated in this study. Without their collaboration this study would not have been possible. Additionally, we thank the training company Downsideup for designing and delivering the training. This program has been funded by the Dutch government, Ministry of Welfare and Sports (VWS), grant 323911. This program would not have been possible without all participating municipal health authorities, local program coordinators, Preventive Child Healthcare organizations and child welfare and social services. We especially thank the Advisory Board of the Healthy Pregnancy 4 All‐2 program.
Publisher Copyright:
© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
PY - 2022/3
Y1 - 2022/3
N2 - Aims This study aims to evaluate the effectiveness of an innovative postnatal risk assessment (the postnatal Rotterdam Reproductive Risk Reduction checklist: R4U) and corresponding care pathways in Preventive Child Healthcare (PCHC), along with PCHC professional satisfaction. Design Four PCHC organizations located in three municipalities with a higher adverse perinatal outcome than the national average were selected for participation. The study concerns a historically controlled study design. Methods The study enrolled participants from September 2016 until December 2017. The historical cohort existed of children born in previous years from 2008 until 2016. The outcome measure was defined as catch-up growth: more than 0.67 standard deviation score weight for height increase in the first 6 months of life. PCHC professional opinion was assessed with a digital survey. Results After the inclusion period, 1,953 children were included in the intervention cohort and 7,436 children in the historical cohort. Catch-up growth was significantly less common in the intervention cohort; 14.9% versus 19.5% in the historical cohort (p < 0.001). A regression sensitivity analysis, using matching, showed an odds ratio of 0.957 (95% CI 0.938-0.976) for the intervention cohort. In the survey, 74 PCHC physicians and nurses participated; most of them were neutral concerning the benefits of the postnatal R4U. Conclusion This study shows that the implementation of a novel postnatal risk assessment including in PCHC is feasible and effective. Final efforts to ensure a widespread implementation should be taken. Impact PCHC offers a unique opportunity to recognize and address risk factors for growth and development in children and to implement care pathways. Effective and widely implemented risk assessments in antenatal and PCHC are scarce. To our knowledge, this kind of evidence-based postnatal risk assessment has not been implemented in PCHC before and seizes the opportunity to prevent catch-up growth and its long-term effects.
AB - Aims This study aims to evaluate the effectiveness of an innovative postnatal risk assessment (the postnatal Rotterdam Reproductive Risk Reduction checklist: R4U) and corresponding care pathways in Preventive Child Healthcare (PCHC), along with PCHC professional satisfaction. Design Four PCHC organizations located in three municipalities with a higher adverse perinatal outcome than the national average were selected for participation. The study concerns a historically controlled study design. Methods The study enrolled participants from September 2016 until December 2017. The historical cohort existed of children born in previous years from 2008 until 2016. The outcome measure was defined as catch-up growth: more than 0.67 standard deviation score weight for height increase in the first 6 months of life. PCHC professional opinion was assessed with a digital survey. Results After the inclusion period, 1,953 children were included in the intervention cohort and 7,436 children in the historical cohort. Catch-up growth was significantly less common in the intervention cohort; 14.9% versus 19.5% in the historical cohort (p < 0.001). A regression sensitivity analysis, using matching, showed an odds ratio of 0.957 (95% CI 0.938-0.976) for the intervention cohort. In the survey, 74 PCHC physicians and nurses participated; most of them were neutral concerning the benefits of the postnatal R4U. Conclusion This study shows that the implementation of a novel postnatal risk assessment including in PCHC is feasible and effective. Final efforts to ensure a widespread implementation should be taken. Impact PCHC offers a unique opportunity to recognize and address risk factors for growth and development in children and to implement care pathways. Effective and widely implemented risk assessments in antenatal and PCHC are scarce. To our knowledge, this kind of evidence-based postnatal risk assessment has not been implemented in PCHC before and seizes the opportunity to prevent catch-up growth and its long-term effects.
KW - catch-up growth
KW - child growth and development
KW - historically controlled study
KW - interdisciplinary collaboration
KW - Preventive Child Healthcare nurses
KW - Preventive Child Healthcare physicians
KW - preventive nursing
KW - risk assessment
KW - INFANT WEIGHT-GAIN
KW - CATCH-UP
KW - BIRTH-WEIGHT
KW - SOCIOECONOMIC-STATUS
KW - BEHAVIOR PROBLEMS
KW - GESTATIONAL-AGE
KW - PRETERM BIRTH
KW - GROWTH
KW - OBESITY
KW - MOTHER
U2 - 10.1111/jan.15003
DO - 10.1111/jan.15003
M3 - Article
C2 - 34590735
SN - 0309-2402
VL - 78
SP - 739
EP - 749
JO - Journal of Advanced Nursing
JF - Journal of Advanced Nursing
IS - 3
ER -