Leslie Laurel K, Hurlburt Michael S, Landsverk John, Rolls Jennifer A, Wood Patricia A, Kelleher Kelly J
University of California San Diego, San Diego, California, USA.
Pediatrics. 2003 Jul;112(1 Pt 1):134-42. doi: 10.1542/peds.112.1.134.
To 1) investigate the status of policies for comprehensive health assessments of children entering out-of-home care, 2) develop a profile for each primary sampling unit (PSU) regarding the comprehensiveness of its assessment policies with respect to physical, mental, and developmental health, and 3) examine the relationship between inclusiveness and the estimated percentage of children assessed, primary assessment location, and principal assessment provider type.
In collaboration with the National Survey of Child and Adolescent Well-Being, a national probability sample of 92 PSUs was identified. Detailed telephone survey data, addressing policies for the assessment of physical, mental, and developmental needs of children on entry into out-of-home care, were collected from child welfare key informants. Descriptive statistics were used for analyses, and were weighted to account for the sampling strategy.
Over 94% of PSUs surveyed assessed all children for physical health problems. The percentage of PSUs with inclusive policies regarding mental health and developmental assessment was much lower (47.8% and 57.8%, respectively). Only 42.6% of PSUs provided comprehensive physical, mental health, and developmental examinations inclusive of all children entering out-of-home care. Community locations and primary care providers were most often used to conduct assessments for physical and developmental problems.
Despite the publication of national guidelines regarding assessment, many PSUs do not have comprehensive policies or routine practices that address all children entering out-of-home care. Given the high use of primary care providers, these providers must be educated regarding the prevalence and types of problems experienced by children entering foster care.
1）调查进入家庭外照料的儿童综合健康评估政策的现状；2）针对每个初级抽样单位（PSU）制定一份关于其在身体、心理和发育健康评估政策全面性方面的概况；3）研究包容性与评估儿童的估计百分比、主要评估地点和主要评估提供者类型之间的关系。
与《全国儿童和青少年福祉调查》合作，确定了92个PSU的全国概率样本。从儿童福利关键信息提供者处收集了详细的电话调查数据，内容涉及儿童进入家庭外照料时身体、心理和发育需求的评估政策。使用描述性统计进行分析，并进行加权以考虑抽样策略。
超过94%的被调查PSU对所有儿童进行了身体健康问题评估。在心理健康和发育评估方面有包容性政策的PSU百分比要低得多（分别为47.8%和57.8%）。只有42.6%的PSU为所有进入家庭外照料的儿童提供了包括身体、心理健康和发育方面的综合检查。社区地点和初级保健提供者最常被用于进行身体和发育问题的评估。
尽管已经发布了关于评估的国家指南，但许多PSU没有针对所有进入家庭外照料的儿童的全面政策或常规做法。鉴于初级保健提供者的高使用率，必须对这些提供者进行关于进入寄养照料的儿童所经历问题的患病率和类型的教育。
