Associations between study questionnaire-assessed need and school doctor-evaluated benefit of routine health checks: an observational study

Nikander, Kirsi; Hermanson, Elina; Vahlberg, Tero; Kaila, Minna; Sannisto, Tuire; Kosola, Silja

doi:10.1186/s12887-021-02810-0

Cited by 3 publications

(7 citation statements)

References 41 publications

(33 reference statements)

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“…Participation rates, reasons for non-participation and doctor-evaluated and parent-evaluated benefits or harm of appointments have been described previously. 13 In brief, with a participation rate of 75.5%, 1013 children participated in the study. This included 506 first graders (age 7–8 years) and 507 fifth graders (age 11–12 years) from 21 public elementary schools.…”

Section: Methodsmentioning

confidence: 99%

“…Our previous research concluded that the concern-based need for a school doctor health check is an important predictor of doctor-evaluated benefit of the health check. 13 According to a systematic review on the effectiveness of school health services, a demand remains for assessment of routinely delivered school health services. 14 The WHO guideline on school health services recommends clarification of what is already being done and by whom, the identification of conditions to be targeted and the set of What is known about the subject?…”

Section: Introductionmentioning

confidence: 99%

“…Our previous research concluded that the concern-based need for a school doctor health check is an important predictor of doctor-evaluated benefit of the health check. 13 …”

Section: Introductionmentioning

confidence: 99%

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Associating school doctor interventions with the benefit of the health check: an observational study

Nikander

Kosola

Vahlberg

et al. 2022

bmjpo

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BackgroundThe benefits of school doctor interventions conducted at routine general health checks remain insufficiently studied. This study explored the associations of school doctor interventions with the doctor-evaluated and parent-evaluated benefits of routine health checks.MethodsBetween August 2017 and August 2018, we recruited a random sample of 1341 children from grades 1 and 5 from 21 Finnish elementary schools in 4 municipalities. Doctors routinely examined all children, who were accompanied by parents. The doctor-reported interventions were categorised into six groups: instructions and/or significant discussions, prescriptions, laboratory tests and/or medical imaging, scheduling of follow-up appointments, referrals to other professionals and referrals to specialised care. Doctors evaluated the benefit of the appointment using predetermined criteria, and parents provided their subjective perceptions of benefit. Interventions and reported benefit were compared using multilevel logistic regression.ResultsDoctors reported 52% and parents 87% of the appointments with interventions beneficial. All interventions were independently associated with doctor-evaluated benefit (ORs: 1.91–17.26). Receiving any intervention during the appointment was associated with parent-evaluated benefit (OR: 3.25, 95% CI 2.22 to 4.75). In analyses of different interventions, instructions and/or significant discussions (OR: 1.71, 95% CI 1.20 to 2.44), prescriptions (OR: 7.44, 95% CI 2.32 to 23.91) and laboratory tests and/or medical imaging (OR: 3.38, 95% CI 1.34 to 8.55) were associated with parent-evaluated benefit. Scheduled follow-up appointments and referrals to other professionals showed no significant association with parent-evaluated benefit.ConclusionsDoctors and parents valued the appointments with interventions. Parents especially appreciated immediate help and testing from the doctor.Trial registration numberNCT03178331.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associating school doctor interventions with the benefit of the health check: an observational study

Nikander

Kosola

Vahlberg

et al. 2022

bmjpo

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“…to questionnaires that assess the concerns of parents, teachers, and nurses regarding each child's physical, mental, and social health. 10 One quarter of children may need special interventions due to physical, mental, and social disorders. 11 In the preventive child healthcare of Netherlands, physicians and nurses identified psychosocial problems in one quarter of school-aged children and undertook actions such as advice or reassurance, consultation, referral to another professional, and/or follow-up for most of them.…”

Section: Open Accessmentioning

confidence: 99%

“…These criteria may be ethically more difficult to accept than criteria based on concerns regarding each child. Our previous research suggested that at least one in four children have no need for a health check by school doctor according to questionnaires that assess the concerns of parents, teachers, and nurses regarding each child’s physical, mental, and social health 10…”

Section: Introductionmentioning

confidence: 99%

Parent, teacher, and nurse concerns and school doctor actions: an observational study of general health checks

et al. 2022

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ObjectiveTo evaluate the association between the concerns of parents, teachers, and nurses regarding each child’s well-being and the school doctor actions conducted in routine general health checks.DesignA blinded, observational study. Prior to the health check parents, teachers, and nurses completed questionnaires assessing their concerns. Doctors, blinded to the responses, routinely examined all children accompanied by parents and reported their actions after each health check. Multilevel logistic regression was used to analyse the association of the concerns with the actions.Setting21 primary schools in four municipalities in Finland.ParticipantsBetween August 2017 and August 2018, we randomly recruited 1341 children from grades 1 and 5, aged 7 and 11 years, respectively.Outcome measuresOutcome measures were the respondents’ concerns and the school doctor actions. The extent of concerns was assessed on a five-point Likert scale. Concern refers to ‘Quite a lot or a great deal of concern’ by at least one respondent. The school doctor actions included instructions and/or significant discussions, prescriptions, laboratory tests and/or medical imaging, scheduling of follow-up appointments, referrals to other professionals, and referrals to specialised care.ResultsAltogether, respondents were concerned about 47.5% of children. The top three concerns comprised growth/and or physical symptoms (22.7%), emotions (16.2%), and concentration (15.1%). All concerns were associated with some type of school doctor action (ORs: 1.66–4.27, p≤0.05); but only concerns regarding growth and/or physical symptoms were associated with all actions. Almost all concerns were associated with referrals to other professionals (ORs: 1.80–4.52, p≤0.01); emotions had the strongest association OR 4.52 (95% CI 3.00 to 6.80, p<0.0001).ConclusionsHealth checks by school doctors may lead to referrals of children to other professionals especially for children’s psychosocial problems. This should be considered when developing the roles, training, and multiprofessional collaboration of school health care professionals.Trial registrationNCT03178331.

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Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis

McCormack,

Wand,

Bourne

et al. 2023

Sex. Health

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Background In the context of an expanding syphilis epidemic, we assessed the integration of sexually transmissible infection (STI) testing within annual health assessments for Aboriginal and Torres Strait Islander young people aged 16–29 years in Aboriginal Community Controlled Health Services between 2018 and 2020. Methods Using routinely collected electronic medical record data from a national sentinel surveillance system (ATLAS), we performed a cross-sectional analysis to calculate the proportion of assessments that integrated any or all of the tests for chlamydia, gonorrhoea, syphilis, and HIV. We used logistic regression to identify correlates of integration of any STI test. Results Of the 13 892 assessments, 23.8% (95% CI 23.1, 24.6) integrated a test for any STI and 11.5% (95% CI 10.9, 12.0) included all four STIs. Of assessments that included a chlamydia/gonorrhoea test, 66.9% concurrently included a syphilis test. Integration of any STI test was associated with patients aged 20–24 years (OR 1.2, 95% CI 1.1–1.4) and 25–29 years (OR 1.1, 95% CI 1.0–1.2) compared to 16–19 years and patients residing in very remote (OR 4.2, 95% CI 3.7–4.8), remote (OR 2.4, 95% CI 2.1–2.8), and regional areas (OR 2.5, 95% CI 2.2–2.8) compared to metropolitan areas. There was no association with patient sex. Conclusions Integration of STI testing into annual health assessments for Aboriginal and Torres Strait Islander young people was higher in remote areas where disease burden is greatest. Integration is similar in men and women, which contrasts with most studies that have found higher testing in women.

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Associations between study questionnaire-assessed need and school doctor-evaluated benefit of routine health checks: an observational study

Cited by 3 publications

References 41 publications

Associating school doctor interventions with the benefit of the health check: an observational study

Associating school doctor interventions with the benefit of the health check: an observational study

Parent, teacher, and nurse concerns and school doctor actions: an observational study of general health checks

Integrating testing for sexually transmissible infections into annual health assessments for Aboriginal and Torres Strait Islander young people: a cross-sectional analysis

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