Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care: Feasibility, acceptability, and predictors of professionals’ adherence to guidelines

    6 Citations (Scopus)

    Abstract

    Background: Infant socioemotional development is often held under informal surveillance, but a formal
    screening program is needed to ensure systematic identification of developmental risk. Even when screening
    programs 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 socioemotional
    problems 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 care
    workers (in this case, health visitors) experience using the instrument? Are attitudes toward using the instrument
    related to screening prevalence rates?
    Design: A longitudinal mixed-method study (surveys, data from the health visitors’ digital filing system, and
    qualitative 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 the
    training on how to use the Alarm Distress Baby Scale to one year after they began using the instrument in
    practice. 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 quantitative
    and open-ended questions (pre- and post-implementation) were used to examine experiences with and attitudes
    towards 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 children
    were screened (the same child was not counted more than once). Most (92%) of the health visitors reported that
    the instrument made a positive contribution to their work. The majority (81%) also reported that it posed a
    challenge in their daily work at least to some degree. The health visitors’ attitudes (positive and negative) toward
    the Alarm Distress Baby Scale, measured 7 months post-implementation, significantly predicted screening prevalence
    rates 12 months post-implementation.
    Conclusions: Adding the Alarm Distress Baby Scale to an established surveillance program is feasible and
    accepTable 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.
    Original languageEnglish
    JournalInternational Journal of Nursing Studies
    Volume79
    Pages (from-to)104-113
    Number of pages10
    ISSN0020-7489
    DOIs
    Publication statusPublished - Mar 2018

    Keywords

    • Acceptability
    • ADBB
    • Early detection
    • Feasibility
    • Health visiting practice
    • Implementation
    • Professionals’ perceptions of universal screening
    • Public health
    • Social withdrawal in infants
    • Universal screening of infants

    Fingerprint

    Dive into the research topics of 'Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care: Feasibility, acceptability, and predictors of professionals’ adherence to guidelines'. Together they form a unique fingerprint.

    Cite this