Risk factors for non-participation in a universal developmental surveillance program in a population in Australia
Chandra Ayer A B R , Valsamma Eapen
C D E , Bronwyn Overs F , Joseph Descallar E G , Bin Jalaludin G H , John Graeme Eastwood G I J K L , Cheryl Dissanayake M , Katrina Williams N O , Elisabeth Murphy P , Susan Woolfenden L Q and for the Watch Me Grow Study Group*
A Royal Far West, PO Box 52, Manly, NSW 1655, Australia.
B Kogarah Diagnostic Assessment Service, St George Hospital, 90 Railway Parade, Kogarah, NSW 2217, Australia.
C Psychiatry Research and Teaching Unit, School of Psychiatry, UNSW, Level 1, Mental Health Centre, Liverpool Hospital, corner Forbes and Campbell Streets, Liverpool, NSW 2170, Australia. Email: v.eapen@unsw.edu.au
D Academic Unit of Child Psychiatry, Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia.
E South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia.
F NeuRA, PO Box 1165, Randwick, NSW 2031, Australia. Email: bronwyn.overs@gmail.com
G Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. Email: joseph.descallar@sswahs.nsw.gov.au; b.jalaludin@unsw.edu.au
H School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia.
I Community Paediatrics, Sydney Local Health District, Level 11 KGV Building, Missenden Road, Camperdown, NSW 2050, Australia. Email: j.eastwood@unsw.edu.au
J School of Public Health, Menzies Centre for Health Policy, University of Sydney, Edward Ford Building, A27 Fisher Road, Sydney, NSW 2006, Australia.
K School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast, Qld 4222, Australia.
L School of Women’s and Children’s Health, UNSW, Sydney, NSW 2052, Australia.
M Olga Tennison Autism Research Centre, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3083, Australia. Email: c.dissanayake@latrobe.edu.au
N Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Vic. 3010, Australia.
O Present address: Department of Paediatrics, Monash University, School of Clinical Sciences, Level 5, Monash Children’s Hospital, 246 Clayton Road, Clayton, Vic. 3168, Australia. Email: Katrina.Williams@monash.edu
P NSW Ministry of Health, Child, Youth and Family Health Services, PO Box 4007, Royal North Shore LPO, St Leonards, NSW 2065, Australia. Email: lmurp@doh.health.nsw.gov.au
Q Department of Community Paediatrics, Sydney Children’s Hospital Network, High Street, Randwick, NSW 2031, Australia. Email: susan.woolfenden@health.nsw.gov.au
R Corresponding author. Email: chandraa@royalfarwest.org.au
Australian Health Review 44(4) 512-520 https://doi.org/10.1071/AH18236
Submitted: 18 January 2019 Accepted: 9 May 2019 Published: 31 July 2020
Journal Compilation © AHHA 2020 Open Access CC BY-NC-ND
Abstract
Objectives This study examined the risk factors for non-participation in a developmental surveillance program in a population in south-west Sydney with a high proportion of culturally diverse and socioeconomically disadvantaged people.
Methods Data from 850 and 625 12- and 18-month-old children respectively from the Watch Me Grow (WMG) birth cohort were used for this study. Logistic regression models were used to assess risk factors for 12- and 18-month non-attendance at Well Child Visits, as well as non-completion of the developmental surveillance questionnaire Parents’ Evaluation of Developmental Status (PEDS) in the child’s personal health record (PHR).
Results Independent risk factors for non-attendance at Well Child Visits were female sex of the child (odds ratio (OR) 12 months 1.5; 95% confidence interval (CI) 1.0–2.3), mother’s country of birth Australia (OR 18 months 1.8; 95% CI 1.2–2.7), annual household income less than A$25 001 (OR 12 months 1.8; 95% CI 1.0–3.2) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 1.7; 95% CI 1.1–2.5). Independent risk factors for non-completion of PEDS in those who did not attend the Well Child Visit compared with those who did attend and did complete PEDS were household annual income at birth less than A$25 001 (OR 12 months 3.9; 95% CI 1.9–8.1) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 2.1 (95% CI 1.2–3.7) and OR 18 months 2.0 (95% CI 1.2–3.6)).
Conclusions In this population, children exposed to socioeconomic disadvantage are less likely to have attended a Well Child Visit and to have a completed PEDS in their PHR at 12 and/or 18 months of age.
What is known about the topic? Developmental problems are common in early childhood, and children from socioeconomically disadvantaged households are at higher risk. Universal developmental surveillance programs may be effective at early identification of children at risk of developmental problems. Early childhood interventions, when accessed, can lessen the effects of developmental problems in later years.
What does this paper add? This paper highlights that children exposed to socioeconomic disadvantage in early childhood who are at higher risk of having developmental problems are also at higher risk of missing out on early identification by non-participation in universal developmental surveillance.
What are the implications for practitioners? A more equitable model of developmental surveillance should include a framework of proportionate universalism to ensure optimal engagement of high-risk population groups.
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