New Model Revolutionizes Child Health Services, Identifies Key Risk Factors
In a groundbreaking development, a new model is set to revolutionize child health services and improve the identification of psychosocial risk factors in households. This model, known as Safe Environment for Every Kid (SEEK), aims to identify children living in families facing economic worries, depressive symptoms, parental stress, intimate partner violence (IPV), and alcohol misuse. By identifying these risk factors, relevant support and assistance can be offered to families in need.
The Swedish child health services (CHS) typically provide health-promoting and primary preventive services to children aged 0 to 6 years. However, until now, the CHS has lacked evidence-based tools to universally screen for the most common psychosocial risk factors. With the implementation of the SEEK model, this gap is finally being addressed, allowing for a more comprehensive assessment of vulnerable children and their families.
To evaluate the effectiveness of the SEEK model, a cluster randomized controlled trial was conducted within the CHS in the county of Dalarna. The trial involved a mixed-method design, including surveys and focus group interviews with CHS nurses. The findings from this study shed light on CHS nurses’ perception of routine assessment of psychosocial risk factors, their self-reported competence, and the organizational conditions in which they operate.
The results of the study showed that CHS nurses had extensive experience in dealing with the targeted risk factors, but using the SEEK model strengthened their sense of competence in identifying and responding to the needs of families facing these challenges. The model bridged the gap between nurses acknowledging the importance and suitability of addressing psychosocial risk factors within the CHS and their previous limited ability to do so.
In addition to evaluating the effectiveness of the SEEK model, the study also examined the psychometric properties of the Swedish version of the Parent Screening Questionnaire (PSQ-S). Data from surveys answered by parents provided valuable insights. The PSQ-S demonstrated a sensitivity of 93%, specificity of 52%, and positive and negative predictive values of 67% and 87%, respectively. These results suggest that the PSQ-S is a reliable tool for screening psychosocial risk factors among parents.
Furthermore, the study analyzed the rates of targeted risk factors among parents who completed the PSQ-S during CHS visits. The analysis revealed that over half of the parents had a positive screening for at least one risk factor, which persisted throughout their child’s first five years of life. The problems were equally prevalent among mothers and fathers. However, there was a significant decrease in the proportion of positive screenings from the beginning to the end of the intervention period, indicating a positive impact of the SEEK model.
Overall, the findings from these studies demonstrate that the SEEK model, when applied in the CHS setting, exhibits a high degree of validity and clinical utility. The experiences of SEEK nurses showcased how the model enhanced their daily work by effectively identifying and addressing psychosocial risk factors. While the model was generally well-received, there is room for improvement in terms of sensitivity regarding intimate partner violence and addressing parents with alcohol misuse.
The implementation of the SEEK model within the Swedish child health services has proven successful in improving the identification of psychosocial risk factors among families. By providing opportunities for assistance that may have otherwise been missed, the model contributes to safeguarding the health and development of children. This innovative approach to child health services sets a promising precedent, not only in Sweden but also globally, to ensure the well-being of young children and support their families during challenging times.
