Effects of a computerised guideline support tool on child healthcare professionals’ response to suspicions of child abuse and neglect: a community-based intervention trial

Annemieke Konijnendijk, Ariana Need, Magda M. Boere-Boonekamp, Riet M.E. Haasnoot-Smallegange

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Abstract

Background
Healthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the seven recommended guideline activities, and on time spent seeking information presented in this guideline.
Methods
A community-based intervention trial design was applied, comparing access to a paper-based guideline (control) with access to a paper-based guideline supplemented with a computerised guideline support tool (intervention). A total of 168 child healthcare doctors and nurses working in one large Dutch organisation were allocated to an intervention or control group. Outcomes were professionals’ performance of seven recommended guideline activities and the amount of time spent seeking information presented in the guideline. Professionals’ adherence was measured using two methods: health record analysis and a self-report questionnaire. The questionnaire was also used to collect data on the amount of time spent seeking guideline information.
Results
In total, 152 health records (102 in the intervention group and 50 in the control group) were available for analysis. The tool was registered in 14% of the records in the intervention group. Performance of activities, corrected for intentional non-adherence, was except for one activity, high (range 80–100%); no differences were found between the control and intervention groups. Forty-nine questionnaires (24 in the intervention group and 25 in the control group) were analysed. Sixty-three percent of the questionnaire respondents (15/24) claimed to have used the tool. No differences in guideline adherence were found between the two groups. Respondents in the intervention and control groups spent, on average, 115 and 153 min respectively seeking relevant information presented in the guideline.
Conclusions
The results regarding use of the tool were inconclusive as the outcomes differed per method. In contrast to expectations, performance of guideline activities was high in both groups. The support tool may decrease the amount of time spent on seeking guideline information. However, given the high adherence scores and small number of questionnaire respondents, the outcomes failed to reach statistical significance. Future research should focus on studying the effects of the tool after a longer period of availability.
Original languageEnglish
Article number161 (2019)
Pages (from-to)1-12
Number of pages12
JournalBMC medical informatics and decision making
Volume19
Issue number161
DOIs
Publication statusPublished - 15 Aug 2019

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Child Abuse
Guidelines
Delivery of Health Care
Control Groups
Guideline Adherence
Surveys and Questionnaires
Health
Self Report
Nurses
Organizations

Keywords

  • Child abuse and neglect
  • Computerised support
  • Guideline adherence
  • Secondary prevention

Cite this

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title = "Effects of a computerised guideline support tool on child healthcare professionals’ response to suspicions of child abuse and neglect: a community-based intervention trial",
abstract = "BackgroundHealthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the seven recommended guideline activities, and on time spent seeking information presented in this guideline.MethodsA community-based intervention trial design was applied, comparing access to a paper-based guideline (control) with access to a paper-based guideline supplemented with a computerised guideline support tool (intervention). A total of 168 child healthcare doctors and nurses working in one large Dutch organisation were allocated to an intervention or control group. Outcomes were professionals’ performance of seven recommended guideline activities and the amount of time spent seeking information presented in the guideline. Professionals’ adherence was measured using two methods: health record analysis and a self-report questionnaire. The questionnaire was also used to collect data on the amount of time spent seeking guideline information.ResultsIn total, 152 health records (102 in the intervention group and 50 in the control group) were available for analysis. The tool was registered in 14{\%} of the records in the intervention group. Performance of activities, corrected for intentional non-adherence, was except for one activity, high (range 80–100{\%}); no differences were found between the control and intervention groups. Forty-nine questionnaires (24 in the intervention group and 25 in the control group) were analysed. Sixty-three percent of the questionnaire respondents (15/24) claimed to have used the tool. No differences in guideline adherence were found between the two groups. Respondents in the intervention and control groups spent, on average, 115 and 153 min respectively seeking relevant information presented in the guideline.ConclusionsThe results regarding use of the tool were inconclusive as the outcomes differed per method. In contrast to expectations, performance of guideline activities was high in both groups. The support tool may decrease the amount of time spent on seeking guideline information. However, given the high adherence scores and small number of questionnaire respondents, the outcomes failed to reach statistical significance. Future research should focus on studying the effects of the tool after a longer period of availability.",
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Effects of a computerised guideline support tool on child healthcare professionals’ response to suspicions of child abuse and neglect : a community-based intervention trial. / Konijnendijk, Annemieke; Need, Ariana ; Boere-Boonekamp, Magda M.; Haasnoot-Smallegange, Riet M.E.

In: BMC medical informatics and decision making, Vol. 19, No. 161, 161 (2019), 15.08.2019, p. 1-12.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Effects of a computerised guideline support tool on child healthcare professionals’ response to suspicions of child abuse and neglect

T2 - a community-based intervention trial

AU - Konijnendijk, Annemieke

AU - Need, Ariana

AU - Boere-Boonekamp, Magda M.

AU - Haasnoot-Smallegange, Riet M.E.

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N2 - BackgroundHealthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the seven recommended guideline activities, and on time spent seeking information presented in this guideline.MethodsA community-based intervention trial design was applied, comparing access to a paper-based guideline (control) with access to a paper-based guideline supplemented with a computerised guideline support tool (intervention). A total of 168 child healthcare doctors and nurses working in one large Dutch organisation were allocated to an intervention or control group. Outcomes were professionals’ performance of seven recommended guideline activities and the amount of time spent seeking information presented in the guideline. Professionals’ adherence was measured using two methods: health record analysis and a self-report questionnaire. The questionnaire was also used to collect data on the amount of time spent seeking guideline information.ResultsIn total, 152 health records (102 in the intervention group and 50 in the control group) were available for analysis. The tool was registered in 14% of the records in the intervention group. Performance of activities, corrected for intentional non-adherence, was except for one activity, high (range 80–100%); no differences were found between the control and intervention groups. Forty-nine questionnaires (24 in the intervention group and 25 in the control group) were analysed. Sixty-three percent of the questionnaire respondents (15/24) claimed to have used the tool. No differences in guideline adherence were found between the two groups. Respondents in the intervention and control groups spent, on average, 115 and 153 min respectively seeking relevant information presented in the guideline.ConclusionsThe results regarding use of the tool were inconclusive as the outcomes differed per method. In contrast to expectations, performance of guideline activities was high in both groups. The support tool may decrease the amount of time spent on seeking guideline information. However, given the high adherence scores and small number of questionnaire respondents, the outcomes failed to reach statistical significance. Future research should focus on studying the effects of the tool after a longer period of availability.

AB - BackgroundHealthcare professionals’ adherence to guidelines on child protection is not self-evident. This study assessed the effects of a computerised support tool on child healthcare professionals’ adherence to the seven recommended guideline activities, and on time spent seeking information presented in this guideline.MethodsA community-based intervention trial design was applied, comparing access to a paper-based guideline (control) with access to a paper-based guideline supplemented with a computerised guideline support tool (intervention). A total of 168 child healthcare doctors and nurses working in one large Dutch organisation were allocated to an intervention or control group. Outcomes were professionals’ performance of seven recommended guideline activities and the amount of time spent seeking information presented in the guideline. Professionals’ adherence was measured using two methods: health record analysis and a self-report questionnaire. The questionnaire was also used to collect data on the amount of time spent seeking guideline information.ResultsIn total, 152 health records (102 in the intervention group and 50 in the control group) were available for analysis. The tool was registered in 14% of the records in the intervention group. Performance of activities, corrected for intentional non-adherence, was except for one activity, high (range 80–100%); no differences were found between the control and intervention groups. Forty-nine questionnaires (24 in the intervention group and 25 in the control group) were analysed. Sixty-three percent of the questionnaire respondents (15/24) claimed to have used the tool. No differences in guideline adherence were found between the two groups. Respondents in the intervention and control groups spent, on average, 115 and 153 min respectively seeking relevant information presented in the guideline.ConclusionsThe results regarding use of the tool were inconclusive as the outcomes differed per method. In contrast to expectations, performance of guideline activities was high in both groups. The support tool may decrease the amount of time spent on seeking guideline information. However, given the high adherence scores and small number of questionnaire respondents, the outcomes failed to reach statistical significance. Future research should focus on studying the effects of the tool after a longer period of availability.

KW - Child abuse and neglect

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