Developmental screening: predictors of follow-up adherence in primary health care.|
Schoeman, Christine Joanné; Swanepoel, De Wet & van der Linde, Jeannie
Background: The importance of early identification for infants and young children with developmental delays is well established.
Poor follow-up on referrals, however, undermines the effectiveness of early intervention programmes.
Objectives: To identify factors, including text message reminders, that influence follow-up adherence for early intervention after
developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default.
Methods: The PEDS tools were used to screen 247 high-risk children. A risk assessment questionnaire was completed with
caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental
correlational study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews
was also employed to determine reasons for follow-up defaults.
Results: Follow-up adherence was 17%. Participants who were never married, divorced or widowed were 2.88 times more likely
to attend a follow-up appointment than those who were married or living together (95%, CI 0.97-8.63). Text message reminders
did not improve follow-up. More than half (58%) of participants who defaulted on appontments could be reached for telephonic
interviews. Interviews showed that 87% of participants were unconcerned about their child’s development. Other reasons for
defaulting were employment, logistical issues, other responsibilities and forgetfulness.
Conclusion: Follow-up adherence for early intervention services following a positive primary health care screen was poor. Increased
awareness and education regarding the importance of development for educational success is needed.
Developmental screening; follow-up return rate; occupational therapy; PEDS tools; primary health care; speech-language therapy; text message reminders