Parental Perceptions of Barriers to Blood Lead Testing

Polivka, Barbara; Gottesman, Mary Margaret

doi:10.1016/j.pedhc.2005.02.007

Cited by 14 publications

(11 citation statements)

References 24 publications

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“…The largest increase in participation occurred after screening was linked with immunization, which is congruent with previous findings that convenience and cultural appropriateness are critical for optimizing screening rates [34, 38, 39]. However we consider it unlikely that participation would have increased as much as it did if the screening method had not been changed to capillary.…”

Section: Discussionsupporting

confidence: 88%

“…However we consider it unlikely that participation would have increased as much as it did if the screening method had not been changed to capillary. Acceptibility to the target population is an important component of screening, and parents are less willing to have children screened if they perceive that the testing method is painful [22, 38]. Moreover, community consultations in Broken Hill had previously identified venous blood collection as contributing to reluctance to have children screened [22].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of introducing point of care capillary testing and linking screening with routine appointments for increasing blood lead screening rates of young children: a before-after study

et al. 2015

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BackgroundLead has significant neuro-toxic effects, particularly for young children. Voluntary screening of pre-school aged children for elevated blood lead levels has been an important part of the lead management program in the mining town of Broken Hill (NSW, Australia) since 1991, where lead remains a significant public health issue for young children despite average blood lead levels having fallen by two-thirds. The annual proportion of children screened declined to 0.39 in 2008. The objective of this study was to determine the impact of changing to capillary screening and linking screening with existing routine health programs on participation in blood lead screening by young children in the community.MethodsWe used a before-after study. Screening rates were determined from routinely collected service data and analysed using cross-sectional and cohort analyses.ResultsThe proportion of children screened annually increased from 0.39 in 2008 to 0.75 in 2012, with the greatest increases among 11–23 and 48–59 month old children. The proportion of children screened at least once by 24 months increased from 0.63 for children born in 2007 to 0.98 for children born in 2010. Attendance stabilized after capillary screening was introduced, and increased markedly after screening was offered at immunization.ConclusonsChanging from venous to capillary screening stabilized attendance and improving convenience was associated with dramatically increased screening. Linking screening with well-accepted mainstream child health programs is an effective strategy to improve participation in blood lead screening programs. The findings have implications for improving participation in other health screening programs.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Effectiveness of introducing point of care capillary testing and linking screening with routine appointments for increasing blood lead screening rates of young children: a before-after study

et al. 2015

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“…Parents have suggested that providing information in the form of brochures, videos, and TV ads, as well as having the ability to draw BLLs on site would facilitate screening. 36 This finding was in concordance with a 1999 survey of Vermont pediatricians that suggested pediatricians with on-site screening have higher screening rates. 37 Furthermore, when broken down into Higher versus Lower Screening groups, physicians in the Higher Screening group, as a trend, reported more barriers to lead screening than those in the Lower Screening group.…”

Section: Discussionsupporting

confidence: 84%

Barriers to Pediatric Lead Screening: Implications From a Web-Based Survey of Vermont Pediatricians

Keeshan

Avener

Abramson

et al. 2010

Clin Pediatr (Phila)

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The pernicious effects of lead on child health are well documented. The Vermont Department of Health (VDH) recommends screening all 12-and 24-month-old children for elevated blood lead levels (BLL). In 2006, only 41.4% of 24-month-old Vermont children were screened. To identify barriers preventing pediatricians from performing blood lead screening, a survey was distributed to Vermont primary care pediatricians-divided in higher and lower screening groups. Vermont pediatricians were more likely to be lower screeners if they reported negative health outcomes began at BLL > 10 mg/dL (odds ratio [OR] = 3.64, 95% confidence interval [CI] = 1.12-11.99), practiced in Chittenden County (OR = 3.34, 95% CI = 1.14-9.78), or disagreed with the VDH's recommendation (OR = 4.90, 95% CI = 1.66-15.50). Adjusted analysis indicated the most significant determinants of lower screening rates were male gender, a perceived dangerous BLL as >10 mg/dL and low self-reported Medicaid population. The VDH may have an opportunity to increase BLL screening emphasizing the significant health risks associated with BLL ≤ 10 mg/dL.

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“…Sometimes BLL screenings were not offered, and when they were, they were not always performed onsite, presenting logistical barriers for parents [48]. Finally, concerns with the discomfort children experienced during invasive blood draws for BLL screening were noted as additional barriers for parents and child caregivers (See also Polivka & Gottesman [49]).…”

Section: Secondary Prevention Through Blood Lead Level (Bll) Monitoringmentioning

confidence: 99%

Resurgent lead poisoning and renewed public attention towards environmental social justice issues: A review of current efforts and call to revitalize primary and secondary lead poisoning prevention for pregnant women, lactating mothers, and children within the U.S.

Neuwirth

2018

International Journal of Occupational and Environmental Health

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The recent Colorado Gold King Mine waste-water spill and Michigan's water supply re-routing program catastrophe, has directed renewed public attention towards resurgent environmental lead contamination threats. Leaded environments present social justice issues for children and mothers possessing blood lead levels (BLLs) > 5 μg/dL. Childhood lead exposure remains a continual U.S. public health problem manifesting in lifelong adverse neuropsychological consequences. The 2007 Inspector General Report demonstrated low BLL screening rates across the U.S. and this study examined the regularity of children's BLL screening rates. The Centers for Disease Control and Prevention (CDC) Lead Poisoning National Surveillance 2010-2014 children's BLL screening rates, were examined to assess BLL screening regularity in states traditionally known to have regularly occurring BLL screenings: New York, New Jersey, and Pennsylvania. The results extracted from the CDC data showed that < 50% of children were BLL screened by six-years of age across the states that were sampled. The findings highlight that without a "clear map" of lead exposed areas through accurate and consistent BLL screenings, how the potential for such disparities within - and between-states within the U.S. could arise due to environmental social justice issues in relation to BLL screening barriers. Barriers preventing children's BLL screenings were considered, and public health interventions recommended to improve screening rates included: routine BLL screening for all pregnant women, lactating mothers, and children; while, removing known lead exposure sources within communities. This study calls for action during a time of renewed public attention to resurgent lead poisoning within the U.S.

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Parental Perceptions of Barriers to Blood Lead Testing

Cited by 14 publications

References 24 publications

Effectiveness of introducing point of care capillary testing and linking screening with routine appointments for increasing blood lead screening rates of young children: a before-after study

Effectiveness of introducing point of care capillary testing and linking screening with routine appointments for increasing blood lead screening rates of young children: a before-after study

Barriers to Pediatric Lead Screening: Implications From a Web-Based Survey of Vermont Pediatricians

Resurgent lead poisoning and renewed public attention towards environmental social justice issues: A review of current efforts and call to revitalize primary and secondary lead poisoning prevention for pregnant women, lactating mothers, and children within the U.S.

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