RESUMO
BACKGROUND: In Germany, about a fifth of families with young children live under psychosocially stressful conditions that can threaten the healthy development of the child. In order to improve the referral of these families from pediatric practices to early childhood intervention services ("Frühe Hilfen"), the PATH intervention was developed and implemented in Baden-Württemberg. The first step in the referral process is to identify psychosocially stressed families. This study investigated whether the PATH intervention increases the proportion of identified families with psychosocial stress by pediatricians. METHOD: In a quasi-experimental study, a total of 293 psychosocially stressed families who were cared for by 29 pediatricians from established pediatric practices were examined. The intervention group (IG) consisted of families with pediatricians from Baden-Württemberg who took part in the PATH intervention. The control group (CG) consisted of families with pediatricians from Bavaria who did not take part in the PATH intervention. Additional qualitative telephone interviews were conducted with 10 pediatricians from the IG and 20 families from the IG with psychosocial stress. RESULTS: A significantly higher proportion of psychosocially stressed families was identified in the IG than in the CG. The difference was about 20 percentage points and was similar regardless of the family's level of stress. DISCUSSION: The results show that the PATH intervention improves the identification of psychosocially stressed families by pediatricians. This improved identification of psychosocially stressed families is an important prerequisite for referring families to tailored early childhood intervention services such as those provided by the "Frühe Hilfen".
RESUMO
BACKGROUND: Family risk factors, e.g. low socioeconomic status or parental mental health disorders, can affect children's health and development. Thus, targeted preventive services for families with psychosocial burden are crucial. The German Early Childhood Intervention (ECI) program is a preventive approach that aims to strengthen parent's resources by supportive services. However, research has revealed that only a proportion of the families considered to have substantial risk factors access the ECI program. To increase pediatricians' skills in identifying risk factors, and to improve the cross-sectoral collaboration between relevant professionals and the referral of families to supportive services, the PATH-intervention (Pediatric Attention To Help) was developed. The PATH-intervention includes interprofessional quality circles and a one-day training program for the pediatricians. This study aims to evaluate this complex cross-sectoral care intervention for families with psychosocial burden. METHODS: Using a prospective quasi-experimental, controlled (matched-pair), longitudinal mixed-method design, we will compare families under treatment of pediatricians trained in the PATH-intervention with families under treatment of a control group of pediatricians. Participating families are asked to complete online-surveys. As a primary outcome, we will examine the use of supportive services of the ECI by burdened families. Secondary outcomes are the proportion of correctly identified families with psychosocial burden by the pediatricians, as well as information provision and motivation of the families to use the supportive services. Additionally, the cost-effectiveness ratio will be investigated. In the process evaluation, we will qualitatively explore the acceptance of the PATH-intervention of all involved stakeholders and the treatment fidelity of the trained pediatricians. DISCUSSION: This study will determine whether the PATH-intervention enables the pediatricians to identify and recommend supportive services to burdened families, as well as the families' use of the supportive services of the ECI. Qualitative data will give insight into the acceptance of the intervention from the perspective of all stakeholders and the treatment fidelity. Results of this study could be the starting point for the broader implementation of the PATH-intervention as standard care. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00023461 (3rd December 2020); WHO UTN: U1111- 260-6575.
Assuntos
Motivação , Criança , Pré-Escolar , Análise Custo-Benefício , Humanos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e QuestionáriosRESUMO
With the declaration of a pandemic situation of national significance by the German Bundestag, the Federal Centre for Health Education (BZgA) is fulfilling its task of providing information for understanding the pandemic situation and implementing the necessary protective measures in a clear manner throughout Germany within the framework of the adapted National Pandemic Plan COVID-19. The BZgA targets its information according to the needs of specific groups and actively involves multipliers.In order to incorporate the perspectives of the population as well as those of prevention and health promotion professionals into the services developed by the BZgA, given the particularly initial low level of knowledge in the population, various methods and data sources were used: the COVID-19 Snapshot Monitoring (COSMO) population survey, the monitoring of citizens' enquiries via telephone and email to the BZgA, surveys of counselling professionals from nationwide telephone and online counselling centres, surveys of health professionals in early help (NZFH) and interdisciplinary practice expert hearings. Beyond providing pure information, practical and everyday offers should be developed and provided according to WHO guidelines and evidence-based criteria of effective communication in order to support the competences for a gradual adaptation to a "new normality".The paper describes the data-based and evidence-informed development process of communication content and offers, their dissemination via existing websites and channels for other topics as well as their integration into the new online platform www.zusammengegencorona.de . This demonstrates how demand-driven and target group-specific communication offers can be implemented beyond the classic and proven campaign appearance.