Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA, Australia.
Kimberley Aboriginal Medical Services, Broome, WA, Australia.
Aust J Rural Health. 2022 Dec;30(6):860-869. doi: 10.1111/ajr.12900. Epub 2022 Jul 8.
Supporting Early Childhood Development (ECD) is an Australian national priority. Aboriginal children in Western Australia's Kimberley region have much higher rates of developmental concerns at school entry than non-Aboriginal children. We aimed to describe ECD practices in the participating service; document follow-up of identified developmental concerns; and identify barriers and enablers to incorporating ECD practices into clinic activity.
Mixed-method design incorporating clinical audit and staff interviews.
An Aboriginal Community Controlled Health Service (ACCHS) in the Kimberley region.
A total of 176 children receiving primary health care through the participating ACCHS; interviews with five ACCHS staff members.
Frequency of developmental enquiry by age and domain; follow-up of identified developmental concerns; and barriers and enablers to ECD practices.
Developmental enquiry was documented for 114 of 176 eligible children (65%), including in 80% of ACCHS child health assessments. Standardised ECD assessments were less common. Staff were aware of the importance of developmental enquiry, however, barriers to increasing ECD practices included a lack of resources and structured staff education, time pressures and a lack of role clarity between the ACCHS and government community health clinic.
This study provides insight into ECD practices in an ACCHS setting, highlighting the potential of primary health care to have an enhanced role in ECD if appropriate systems, training and tools are provided. A lack of role clarity across services, combined with poor communication between services, creates a potential risk for missed opportunities to support ECD.
支持儿童早期发展（ECD）是澳大利亚的国家重点。西澳大利亚金伯利地区的土著儿童在入学时比非土著儿童发育问题的发生率更高。我们旨在描述参与服务的 ECD 实践；记录已确定的发育问题的后续情况；并确定将 ECD 实践纳入临床活动的障碍和促进因素。
结合临床审计和员工访谈的混合方法设计。
金伯利地区的一个土著社区控制的医疗服务机构（ACCHS）。
共有 176 名通过参与的 ACCHS 接受初级医疗保健的儿童；对五名 ACCHS 工作人员进行访谈。
按年龄和领域进行发育询问的频率；已确定的发育问题的后续情况；以及 ECD 实践的障碍和促进因素。
有 176 名符合条件的儿童中有 114 名（65%）记录了发育询问，包括在 80%的 ACCHS 儿童健康评估中。标准化的 ECD 评估则较为少见。工作人员意识到发育询问的重要性，但增加 ECD 实践的障碍包括资源和结构化员工教育的缺乏、时间压力以及 ACCHS 和政府社区医疗诊所之间角色不明确。
本研究深入了解了 ACCHS 环境中的 ECD 实践，强调了如果提供适当的系统、培训和工具，初级保健在 ECD 中可以发挥更大的作用。服务之间角色不明确，加上服务之间沟通不畅，可能会错失支持 ECD 的机会。
