What is new?
Background
Methods
Study sample
Procedure
Measures
Child, family and CHP background characteristics
Statistical analysis
Results
Total | CHP identified psychosocial problems | Parental concerns | |||
---|---|---|---|---|---|
% n, n = 3,870 | No % n, n = 3,193 | Yes % n, n = 677 | No % n, n = 2,388 | Yes % n, n = 1,482 | |
Total Sample | 82.5 | 17.5 | 61.7 | 38.3 | |
Child: CBCL/ITSEA problem score | *** | *** | |||
No clinical score | 95.3 | 97.0 | 87.4 | 98.7 | 89.9 |
Clinical score | 4.7 | 3.0 | 12.6 | 1.3 | 10.1 |
Child: history of problems |
***
|
***
| |||
No | 84.3 | 90.2 | 56.3 | 88.9 | 76.7 |
Yes | 15.7 | 9.8 | 43.7 | 11.1 | 23.3 |
Environmental: Life events | ** | *** | |||
No | 88.9 | 89.9 | 84.2 | 90.5 | 86.2 |
Yes | 11.1 | 10.1 | 15.8 | 9.5 | 13.8 |
Parenting: Parenting efficacy | *** | *** | |||
Efficacy | 77.1 | 79.0 | 68.1 | 82.5 | 68.5 |
Low efficacy | 22.9 | 21.0 | 31.9 | 17.5 | 31.5 |
Gender | *** | ||||
Girl | 51.1 | 52.6 | 44.0 | 52.0 | 49.7 |
Boy | 48.9 | 47.4 | 56.0 | 48.0 | 50.3 |
Ethnicity | * | ||||
Industrialized country | 81.3 | 82.0 | 78.0 | 79.9 | 80.5 |
Non-Industrialized country | 19.7 | 18.0 | 22.0 | 20.1 | 19.4 |
Age | *** | *** | |||
14 months | 18.8 | 20.7 | 9.6 | 18.1 | 19.8 |
3 years 9 months | 18.2 | 18.9 | 14.6 | 16.3 | 21.3 |
5/6 years | 34.3 | 31.3 | 48.2 | 33.6 | 35.4 |
8–12 years | 28.8 | 29.0 | 27.6 | 32.0 | 23.5 |
Educational level | *** | ||||
Low | 38.0 | 36.5 | 45.2 | 39.3 | 35.8 |
Average | 36.0 | 36.5 | 33.4 | 35.3 | 37.2 |
High | 24.3 | 25.2 | 19.8 | 23.6 | 25.4 |
Unknown | 1.7 | 1.7 | 1.6 | 1.7 | 1.6 |
CHP’s use of screening instruments | *** | *** | |||
Never | 83.0 | 83.9 | 78.9 | 83.0 | 83.0 |
When indicated | 11,3 | 11.0 | 12.4 | 11.1 | 11.5 |
At each assessment | 5.7 | 5.1 | 8.7 | 5.9 | 5.5 |
Combination child, parenting, environmental stressors | *** | *** | |||
Not in child and parenting/context | 60.1 | 65.5 | 34.3 | 68.6 | 46.4 |
Not in child but in parenting/context | 21.2 | 22.3 | 16.2 | 19.3 | 24.3 |
In child, but not in parenting/context | 10.1 | 6.9 | 25.4 | 7.7 | 14.1 |
Both in child and parenting/context | 8.6 | 5.3 | 24.1 | 4.4 | 15.2 |
CHP-parent agree on child having no problems %n, n = 2,086 | Parents have concerns but CHP identifies no problems %n, n = 1,107 | Parents have no concerns, CHP identifies problems %n, n = 302 | Parents and CHP agree that child has problems % n, n = 375 | |
---|---|---|---|---|
Total sample | 53.9 | 28.6 | 7.8 | 9.7 |
Child: CBCL/ITSEA problem score | *** | |||
No clinical score | 99.1 | 93.0 | 95.7 | 80.8 |
Clinical score | 0.9 | 7.0 | 4.3 | 19.2 |
Child: history of problems | *** | |||
No | 92.4 | 86.1 | 65.2 | 49.1 |
Yes | 7.6 | 13.9 | 34.8 | 50.9 |
Environmental: Life events |
***
| |||
No | 91.4 | 86.9 | 84.1 | 84.3 |
Yes | 8.6 | 13.1 | 15.9 | 15.7 |
Parenting: Parenting efficacy | *** | |||
Higher efficacy | 83.0 | 71.5 | 78.5 | 59.7 |
Lower efficacy | 17.0 | 28.5 | 21.5 | 40.3 |
Gender | ** | |||
Girl | 53.0 | 52.0 | 45.7 | 42.7 |
Boy | 47.0 | 48.0 | 54.3 | 57.3 |
Ethnicity | ||||
Industrialized country | 81.7 | 82.5 | 77.2 | 78.7 |
Non-Industrialized country | 18.3 | 17.5 | 22.8 | 21.3 |
Age | *** | |||
14 months | 19.6 | 22.8 | 7.9 | 10.9 |
3 years 9 months | 16.9 | 22.9 | 12.3 | 16.5 |
5/6 years | 31.4 | 31.3 | 48.7 | 47.7 |
8–12 years | 32.1 | 23.1 | 31.1 | 24.8 |
Educational level | ** | |||
Low | 38.1 | 33.3 | 47.7 | 43.2 |
Average | 36.0 | 37.8 | 30.8 | 35.5 |
High | 24.2 | 27.2 | 19.5 | 20.0 |
Unknown | 1.7 | 1.7 | 2.0 | 1.3 |
CHP’s use of screening instruments | ** | |||
Never | 83.6 | 84.5 | 79.1 | 78.7 |
When indicated | 11.1 | 10.9 | 11.3 | 13.3 |
At each assessment | 5.4 | 4.6 | 9.6 | 8.0 |
Combination child, parenting, environmental stressors | *** | |||
Not in child and parenting/context | 71.8 | 53.7 | 46.0 | 24.8 |
Not in child but in parenting/context | 19.8 | 27.1 | 16.6 | 16.0 |
In child, but not in parenting/context | 5.4 | 9.8 | 23.5 | 26.9 |
Both in child and parenting/context | 3.1 | 9.5 | 13.9 | 32.3 |
CHP identifies problems | Parents have concerns | |||||
---|---|---|---|---|---|---|
% CHP identified problems | Unadjusted OR (95 % CI) n = 3,870 | Adjusted OR# (95 % CI) n = 3,870 | % parental concern | Unadjusted OR (95 % CI) n = 3,870 | Adjusted OR# (95 % CI) n = 3,870 | |
Child: CBCL/ITSEA problem score | ||||||
No clinical score$ | 16.0 | 1 | 1 | 36.0 | 1 | 1 |
Clinical score | 47.2 |
4.66 (3.37–6.44)
|
3.43 (2.41–4.89)
| 82.8 |
8.63 (6.17–12.07)
|
7.69 (5.39–10.97)
|
Child: history of problems | ||||||
No$ | 11.7 | 1 | 1 | 34.9 | 1 | 1 |
Yes | 48.6 |
6.56 (5.29–8.14)
|
5.85 (4.75–7.21)
| 56.7 |
2.47 (2.05–2.98)
|
2.28 (1.91–2.73)
|
Environmental: life events | ||||||
No$ | 16.6 | 1 | 1 | 37.2 | 1 | 1 |
Yes | 24.8 |
1.60 (1.25–2.05)
| 1.20 (0.92–1.59) | 47.3 |
1.54 (1.23–1.93)
|
1.55 (1.21–1.99)
|
Parenting: Parenting efficacy | ||||||
Higher efficacy$ | 15.4 | 1 | 1 | 34.0 | 1 | 1 |
Lower efficacy | 24.4 |
1.73 (1.43–2.09)
|
1.28 (1.05–1.56)
| 52.7 |
2.17 (1.88–2.51)
|
1.92 (1.65–2.23)
|
Gender | ||||||
Girl$ | 15.1 | 1 | 1 | 37.2 | 1 | 1 |
Boy | 20.0 |
1.38 (1.18–1.61)
|
1.21 (1.02–1.43)
| 39.5 | 1.10 (0.96–1.25) | 0.98 (0.85–1.12) |
Ethnicity | ||||||
Industrialized country$ | 16.8 | 1 | 1 | 38.4 | 1 | 1 |
Non-Industrialized country | 20.6 |
1.27 (1.18–1.61)
| 0.87 (0.66–1.14) | 37.8 | 0.99 (0.83–1.18) |
0.78 (0.64–0.94)
|
Age | ||||||
14 months$ | 9.0 | 1 | 1 | 40.4 | 1 | 1 |
3 years 9 months | 14,1 |
1.67 (1.04–2.68)
| 1.39 (0.89–2.16) | 44.7 | 1.20 (0.97–1.48) | 1.14 (0.91–1.42) |
5/6 years | 24.6 |
3.20 (2.03–5.04)
|
2.49 (1.55–4.00)
| 39.6 | 0.96 (0.77–1.21) | 0.90 (0.71–1.14) |
8–12 years | 16.8 |
2.40 (1.53–3.77)
|
1.61 (1.00–2.58)
| 31.4 |
0.67 (0.53–0.85)
|
0.60 (0.47–0.76)
|
Educational level | ||||||
Low$ | 20.8 | 1 | 1 | 36.1 | 1 | 1 |
Average | 16.2 |
0.72 (0.59–0.88)
| 0.85 (0.69–1.05) | 39.5 | 1.04 (0.66–1.64) |
1.25 (1.05–1.50)
|
High | 14.3 |
0.56 (0.44–0.72)
|
0.70 (0.53–0.91)
| 40.0 | 1.16 (0.96–1.40) |
1.39 (1.13–1.71)
|
Unknown | 16.9 | 0.74 (0.41–1.34) | 0.62 (0.35–1.08) | 36.9 | 1.14 (0.98–1.34) |
1.10 (0,66–1.82)
|
CHP’s use of screening instruments | ||||||
Never$ | 16.6 | 1 | 1 | 38.3 | 1 | 1 |
When indicated | 19.3 | 1.16 (0.81–1.66) |
1.53 (1.10–2.14)
| 39.2 | 1.06 (0.75–1.50) | 1.00 (0.73–1.37) |
At each assessment | 26.6 |
1.85 (1.27–2.70)
| 1.38 (0.86–2.22) | 36.5 | 0.93 (0.71–1.22) | 0.90 (0.72–1.14) |
Combination child, parenting, environmental stressors | & | & | ||||
Not in child and parenting/context$ | 10.0 |
1
| 1 | 29.6 |
1
|
1
|
Not in child but in parenting/context | 13.4 |
1.33 (1.01–1.76)
| 1.28 (0.96–1.71) | 43.8 |
1.88 (1.59–2.22)
|
2.11 (1.77–2.51)
|
In child, but not in parenting/context | 43.9 |
6.40 (4.90–8.38)
|
6.20 (4.72–8.13)
| 53.3 |
2.78 (2.21–3.48)
|
3.11 (2.47–3.91)
|
Both in child and parenting/context | 49.1 |
8.16 (6.22–10.70)
|
7.84 (5.85–10.51)
| 68.1 |
5.20 (4.26–6.36)
|
6.24 (5.04–7.73)
|
Reference: CHP-parent agreement on the child having no psychosocial problems (n = 2,086) | ||||
---|---|---|---|---|
% children on which CHP and parent agree there are problems | Parents have concerns but CHP identifies no problems OR (95 % CI)# n = 1,107 | Parents have no concerns but CHP identifies problems OR (95 % CI)# n = 302 | Parents and CHP agree that child has problems OR (95 % CI)# n = 375 | |
Child: CBCL/ITSEA total problem score | ||||
No clinical score$ | 8.2 | 1 | 1 | 1 |
Clinical score | 40.0 |
8.57 (5.03–14.61)
|
4.44 (2.10–9.37)
|
22.38 (12.56–39.88)
|
Child: history of problems | ||||
No$ | 5.6 | 1 | 1 | 1 |
Yes | 31.4 |
1.93 (1.51–2.46)
|
5.78 (4.31–7.76)
|
11.26 (8.53–14.87)
|
Environmental: Stressful situations | ||||
No$ | 9.2 | 1 | 1 | 1 |
Yes | 13.7 |
1.77 (1.36–2.30)
|
1.55 (1.05–2.27)
|
1.50 (1.03–2.20)
|
Parenting: Parenting efficacy | ||||
Higher efficacy$ | 7.5 | 1 | 1 | 1 |
Lower efficacy | 17.0 |
1.82 (1.52–2.19)
| 1.11 (0.81–1.52) |
2.45 (1.87–3.20)
|
Gender | ||||
Girl$ | 8.1 | 1 | 1 | 1 |
Boy | 11.4 | 0.96 (0.83–1.12) | 1.25 (0.97–1.61) | 1.20 (0.93–1.53) |
Ethnicity | ||||
Industrialized country$ | 9.4 | 1 | 1 | 1 |
Non-Industrialized country | 11.0 |
0.78 (0.62–0.98)
| 0.86 (0.61–1.21) |
0.66 (0.47–0.93)
|
Age | ||||
14 months$ | 5.6 | 1 | 1 | 1 |
3 years 9 months | 8.8 | 1.15 (0.91–1.44) | 1.66 (0.97–2.84) | 1.46 (0.92–2.31) |
5/6 years | 13.5 | 0.84 (0.68–1.04) |
3.25 (2.04–5.17)
|
2.55 (1.71–3.82)
|
8–12 years | 8.4 |
0.58 (0.46–0.73)
|
1.83 (1.13–2.96)
| 1.00 (0.65–1.55) |
Educational level | ||||
Low$ | 11.0 | 1 | 1 | 1 |
Average | 9.5 |
1.25 (1.04–1.51)
| 0.85 (0.63–1.14) | 1.14 (0.85–1.53) |
High | 8.0 |
1.43 (1.17–1.74)
| 0.76 (0.54–1.07) | 1.05 (0.74–1.47) |
Unknown | 7.7 | 1.24 (0.68–2.25) | 0.81 (0.32–2.05) | 0.60 (0.21–1.74) |
CHP’s use of screening instruments | ||||
Never$ | 9.2 | 1 | 1 | 1 |
When indicated | 11.5 | 0.93 (0.73–1.19) | 1.35 (0.90–2.02) |
1.61 (1.10–2.35)
|
At each assessment | 13.5 | 0.91 ((0.64–1.30) | 1.27 (0.80–2.01) | 1.03 (0.64–1.67) |
Combination child, parent, environmental stressors | & | & | & | |
Not in child and parenting/context$ | 4.0 | 1 | 1 | 1 |
Not in child but in parenting/context | 7.3 |
2.08 (1.73–2.51)
| 1.21 (0.85–1.73) |
2.51 (1.77–3.58)
|
In child, but not in parenting/context | 25.8 |
2.76 (2.07–3.67)
|
6.26 (4.39–8.91)
|
15.39 (10.84–21.86)
|
Both in child and parenting/context | 36.4 |
5.05 (3.61–7.07)
|
6.67 (4.28–10.40)
|
35.58 (24.11–52.48)
|