198938 Importance of evidence based developmental screening in community health clinics that serve low SES Latino population

Wednesday, November 11, 2009: 8:50 AM

Gowri Madhavan, MPH , Epidemiologist, Family Health Division, Health Care Agency, County of Orange, Santa Ana, CA
Eric G. Walsh, MD, MPH , Family Health Division/Nutrition Services, Health Care Agency, County of Orange, Santa Ana, CA
Conchita L. Del Mundo, MD, FAAP , Public Health Officer, Family Health Clinics, Health Care Agency, County of Orange, Santa Ana, CA
Introduction: Estimates state 16% of American children have developmental or behavioral disorders. In Orange County California, the Santa Ana (SA) and Buena Park (BP) public health clinics were conducting non evidence based developmental screening tools. In 2007, both clinics provided a total of 1865 unduplicated physical exams for children less than 5 years of age. Of those 1865 unduplicated exams, 2.8% (52 clients) were referred for further evaluation.

Objectives: To assess the differences in usability and rate of referrals between ASQ and PEDS at two clinics. The study also looks at the positive predictive value of each test when used in a lower SES/Latino population. The study will also compare established referral rates for each tool with the referral rates of the study population.

Methods: Starting in May of 2008 for a four month period BP exclusively administered the PEDS screening tool while SA clinic exclusively used the ASQ. Rates were compared pre and post implementation of pilot. Beginning February 2009 referred children were followed up on for 2007 and the pilot study period for services rendered and final disposition.

Results: The ASQ was administered to 116 and the PEDS to 289 children. Preliminary results: ASQ 8 (6.8%) with no concerns/risk factors present and 29 (25.0%) were recommended for assessment. PEDS 47 (16.3%) with no concerns/risk factors present and 54 (18.7%) were recommended for assessment.

Conclusion: Study will present the above data in more detail as well as the results of follow up on final disposition of referred children.

Learning Objectives:
At the end of the session, the participants will be able to: 1.Compare the advantages and disadvantages of using either PEDS or ASQ in community health clinics. 2.Demonstrate usability and effectiveness of evidence based screening tools in a predominantly lower SES Latino population. 3.Identify the importance of the follow up and evaluation of developmental screening efforts in community health clinics.

Keywords: Children, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have presented before public health audiences and I am also involved in public health publications with the Health Care Agency, County of Orange, California.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.