TY - JOUR

T1 - Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care:

T2 - Feasibility, acceptability, and predictors of professionals’ adherence to guidelines

AU - Smith-Nielsen, Johanne

AU - Lønfeldt, Nicole Nadine

AU - Guedeney, Antoine

AU - Væver, Mette Skovgaard

PY - 2018/3

Y1 - 2018/3

N2 - Background: Infant socioemotional development is often held under informal surveillance, but a formalscreening program is needed to ensure systematic identification of developmental risk. Even when screeningprograms exist, they are often ineffective because health care professionals do not adhere to screening guidelines,resulting in low screening prevalence rates.Objectives: To examine feasibility and acceptability of implementing universal screening for infant socioemotionalproblems with the Alarm Distress Baby Scale in primary care. The following questions were addressed:Is it possible to obtain acceptable screening prevalence rates within a 1-year period? How do the primary careworkers (in this case, health visitors) experience using the instrument? Are attitudes toward using the instrumentrelated to screening prevalence rates?Design: A longitudinal mixed-method study (surveys, data from the health visitors’ digital filing system, andqualitative coding of answers to open-ended questions) was undertaken.Setting and participants: Health visitors in three of five districts of the City of Copenhagen, Denmark (N =79).Methods: We describe and evaluate the implementation process from the date the health visitors started thetraining on how to use the Alarm Distress Baby Scale to one year after they began using the instrument inpractice. To monitor screening prevalence rates and adherence to guidelines, we used three data extractions (6,9, and 12 months post-implementation) from the electronic filing system. Surveys including both quantitativeand open-ended questions (pre- and post-implementation) were used to examine experiences with and attitudestowards the instrument. Descriptive and inferential statistical and qualitative content analyses were used.Results: Screening prevalence rates increased during the first year: Six months after implementation 47%(n=405) of the children had been screened; 12 months after implementation 79% (n=789) of the childrenwere screened (the same child was not counted more than once). Most (92%) of the health visitors reported thatthe instrument made a positive contribution to their work. The majority (81%) also reported that it posed achallenge in their daily work at least to some degree. The health visitors’ attitudes (positive and negative) towardthe Alarm Distress Baby Scale, measured 7 months post-implementation, significantly predicted screening prevalencerates 12 months post-implementation.Conclusions: Adding the Alarm Distress Baby Scale to an established surveillance program is feasible andaccepTable Screening prevalence rates may be related to the primary care worker’s attitude toward the instrument,i.e. successful implementation relies on an instrument that adds value to the work of the screener.

AB - Background: Infant socioemotional development is often held under informal surveillance, but a formalscreening program is needed to ensure systematic identification of developmental risk. Even when screeningprograms exist, they are often ineffective because health care professionals do not adhere to screening guidelines,resulting in low screening prevalence rates.Objectives: To examine feasibility and acceptability of implementing universal screening for infant socioemotionalproblems with the Alarm Distress Baby Scale in primary care. The following questions were addressed:Is it possible to obtain acceptable screening prevalence rates within a 1-year period? How do the primary careworkers (in this case, health visitors) experience using the instrument? Are attitudes toward using the instrumentrelated to screening prevalence rates?Design: A longitudinal mixed-method study (surveys, data from the health visitors’ digital filing system, andqualitative coding of answers to open-ended questions) was undertaken.Setting and participants: Health visitors in three of five districts of the City of Copenhagen, Denmark (N =79).Methods: We describe and evaluate the implementation process from the date the health visitors started thetraining on how to use the Alarm Distress Baby Scale to one year after they began using the instrument inpractice. To monitor screening prevalence rates and adherence to guidelines, we used three data extractions (6,9, and 12 months post-implementation) from the electronic filing system. Surveys including both quantitativeand open-ended questions (pre- and post-implementation) were used to examine experiences with and attitudestowards the instrument. Descriptive and inferential statistical and qualitative content analyses were used.Results: Screening prevalence rates increased during the first year: Six months after implementation 47%(n=405) of the children had been screened; 12 months after implementation 79% (n=789) of the childrenwere screened (the same child was not counted more than once). Most (92%) of the health visitors reported thatthe instrument made a positive contribution to their work. The majority (81%) also reported that it posed achallenge in their daily work at least to some degree. The health visitors’ attitudes (positive and negative) towardthe Alarm Distress Baby Scale, measured 7 months post-implementation, significantly predicted screening prevalencerates 12 months post-implementation.Conclusions: Adding the Alarm Distress Baby Scale to an established surveillance program is feasible andaccepTable Screening prevalence rates may be related to the primary care worker’s attitude toward the instrument,i.e. successful implementation relies on an instrument that adds value to the work of the screener.

KW - Acceptability

KW - ADBB

KW - Early detection

KW - Feasibility

KW - Health visiting practice

KW - Implementation

KW - Professionals’ perceptions of universal screening

KW - Public health

KW - Social withdrawal in infants

KW - Universal screening of infants

U2 - 10.1016/j.ijnurstu.2017.11.005

DO - 10.1016/j.ijnurstu.2017.11.005

M3 - Journal article

C2 - 29223624

VL - 79

SP - 104

EP - 113

JO - Nursing

JF - Nursing

SN - 0020-7489

ER -