Screening tools used in primary health care settings to identify health behaviours in children (birth – 16 years); A systematic review of their effectiveness, feasibility and acceptability

Abstract

BackgroundChild health behaviour screening tools used in primary health care have potential as a transformative and effective strategy to support growth monitoring and the early identification of suboptimal behaviours to target strategies for intervention. This systematic review aimed to examine the effectiveness, acceptability and feasibility of child health behaviour screening tools used in primary health care settings.MethodsA systematic review of studies published in English in five databases (CINAHL, Medline, Scopus, PsycINFO and Web of Science) prior to July 2022 was undertaken using a PROSPERO protocol and PRISMA guidelines. Eligible studies: 1) described screening tools for health behaviours (dietary, physical activity, sedentary or sleep-related behaviours) used in primary health care settings in children birth to 16 years of age; 2) reported their acceptability, feasibility or effectiveness on child or practitioner behaviour or 3) reported implementation of the screening tool. Study selection and data extraction were conducted in duplicate. Results were narratively synthesised.ResultsOf the 7145 papers identified, 22 studies reporting on 14 unique screening tools were included. Four screening tools measured diet, physical activity, sedentary and sleep behaviours domains, with most screening tools only measuring two or three behaviour domains. Ten studies reported screening tools were effective in changing practitioner self-reported behaviour, knowledge, self-efficacy and provision of health behaviour education. Administration of screening tools varied across studies including mode, timing and caregiver or practitioner completion. Implementation strategies described included practitioner training and integration into electronic medical records. Practitioners and caregivers identified numerous benefits and challenges to screening; however, child views were not captured.ConclusionsFew screening tools exist to facilitate comprehensive screening of children’s health behaviours in primary health care. This review highlights the potential of health behaviour screening as an acceptable and feasible strategy to comprehensively assess and provide early intervention for children’s health behaviours in primary health care settings.Potential conflicts of interestAll authors have no conflicts of interest to declare.

Development and validation of a short dietary questionnaire for assessing obesity‐related dietary behaviours in young children

“…Further, they allow for easy comparison of food group intake against dietary guidelines (National Institutes of Health National Cancer Institute, n.d.; NIHR Cambridge Biomedical Research Centre, n.d.). Existing short questionnaires validated in Australian populations assess various aspects of diet, predominantly diet quality against dietary guidelines and have been developed for populations ranging from 12 months to 16 years of age (Bell et al, 2013;Dutch et al, 2023;Golley et al, 2017). For example, the 28-item Children's Dietary Questionnaire assesses the intake of 4-16-year-old children for positive indicators (i.e., vegetables, fruit, water, reduced fat products) and negative indicators (i.e., high fat/high sugar foods and beverages) of diet quality (Magarey et al, 2009).…”

“…Further to this, a recent review highlighted a lack of validated and reliable short diet questionnaires that measure obesity‐related dietary behaviours in young children (<5 years) (Byrne et al, 2019 ). Reviews of short dietary questionnaires highlight the lack of validated and ‘fit‐for‐purpose’ dietary assessment tools for use with infants, toddlers and pre‐school‐aged children that are feasible for use in policy and practice settings as a screening instrument to identify behaviours that place children at higher risk of poor growth, health and development (Byrne et al, 2019 ; Dutch et al, 2023 ; Golley et al, 2017 ). Therefore, this study aimed to (1) develop a short dietary questionnaire feasible for use in research and practice that assesses obesity‐related dietary behaviours of young children aged 6 months to 5 years and (2) examine the validity and reliability of the short dietary questionnaire.…”