Young Nancy L, Jacko Diane, Wabano Mary Jo, Hawthorne Lauren, Seabrook Sarah, Wabanosse Sheri, Usuba Koyo
Laurentian University, Sudbury, ON.
Can J Public Health. 2016 Dec 27;107(4-5):e399-e403. doi: 10.17269/cjph.107.5539.
The Aboriginal Children's Health and Well-Being Measure© (ACHWM) was developed to assess health from the perspectives of Aboriginal children. The purpose of this paper is to document the screening process, embedded within the ACHWM, and assess its effectiveness.
The ACHWM was implemented in 2014/2015 with children 8 to 18 years of age living on the Wiikwemkoong Unceded Territory. Survey responses were screened to identify potential risk, using an automated algorithm run on computer tablets. Local mental health workers conducted brief mental health assessments to identify and support children at-risk. Data were analyzed to estimate effectiveness of this screening process.
A total of 293 children completed the ACHWM. The screening tool identified 35% with potential risk. Mental health workers confirmed 18% of all participants as being at-risk, and all were referred for support. The sensitivity of the tool was 75% while specificity was 79%. Improvements to the screening algorithm resulted in a specificity of 97% and negative predictive value of 95%, with no loss of sensitivity.
Responsible population health surveys require a process to recognize and respond to answers indicative of health risks. This paper provides an example of a screening and triage process that enabled our survey team to screen responses in real time, respond to potential risk immediately, and connect participants to local support services. This process proved essential to conducting an ethical survey. The high specificity and negative predictive value make it an effective triage tool that is particularly valuable in Aboriginal communities and with higher-risk populations.
“原住民儿童健康与幸福衡量标准”（ACHWM）旨在从原住民儿童的角度评估健康状况。本文旨在记录ACHWM中包含的筛查过程，并评估其有效性。
2014/2015年，ACHWM在生活于维克温孔未被割让土地上的8至18岁儿童中实施。利用在电脑平板电脑上运行的自动算法对调查问卷的回复进行筛查，以识别潜在风险。当地心理健康工作者进行简短的心理健康评估，以识别和支持有风险的儿童。对数据进行分析，以评估这种筛查过程的有效性。
共有293名儿童完成了ACHWM。筛查工具识别出35%的儿童有潜在风险。心理健康工作者确认所有参与者中有18%处于风险中，所有这些儿童都被转介接受支持。该工具的敏感性为75%，特异性为79%。对筛查算法的改进使特异性达到97%，阴性预测值达到95%，且敏感性没有损失。
负责任的人群健康调查需要一个过程来识别和应对表明健康风险的答案。本文提供了一个筛查和分诊过程的示例，该过程使我们的调查团队能够实时筛查回复，立即应对潜在风险，并将参与者与当地支持服务联系起来。这一过程被证明对进行符合道德规范的调查至关重要。高特异性和阴性预测值使其成为一种有效的分诊工具，在原住民社区和高危人群中尤其有价值。
