In-house consultation to support professionals’ responses to child abuse and neglect: Determinants of professionals’ use and the association with guideline adherence |
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| Institution: | 1. Departments of Health Technology and Services Research, and Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands;2. Department of Health Technology and Services Research, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands;3. Department of Preventive Child Health Care, Municipal Health Service GGD Twente, Enschede, The Netherlands;4. Department of Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands;1. Division of General Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States;2. Division of Emergency Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States;3. PolicyLab, The Children’s Hospital of Philadelphia, Philadelphia, PA, United States;4. Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, United States;1. International Rescue Committee, 122 E 42nd St, New York City, NY, 10168 USA;2. Columbia University Mailman School of Public Health, 60 Haven Avenue, B-4, Suite 432, New York, NY 10032, USA;3. International Rescue Committee,3 Bloomsbury Place, London, WC1A 2QL, United Kingdom;4. International Rescue Committee, Bukavu, South-Kivu, Democratic Republic of the Congo |
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| Abstract: | This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals’ performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study’s inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p = .001), who were more familiar with consultation (p = .002), who had more positive attitudes and beliefs about consultation (p = .011) and who reported being more susceptible to the behavior (p = .001) and expectations/opinions (p = .025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals’ responses to CAN are discussed. |
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| Keywords: | Child abuse and neglect Consultation Clinical decision making Preventive child health care Quality of care |
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