18个月健康监督访视时家庭收入与使用婴幼儿发育筛查清单进行的阳性发育筛查之间的关联

Association Between Family Income and Positive Developmental Screening Using the Infant Toddler Checklist at the 18-Month Health Supervision Visit.

作者信息

Nurse Kimberly M, Parkin Patricia C, Keown-Stoneman Charles D G, Bayoumi Imaan, Birken Catherine S, Maguire Jonathon L, Macarthur Colin, Borkhoff Cornelia M

机构信息

Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Pediatr. 2024 Jan;264:113769. doi: 10.1016/j.jpeds.2023.113769. Epub 2023 Nov 1.

DOI:10.1016/j.jpeds.2023.113769

PMID:37821023

Abstract

OBJECTIVE

To examine the associations between several potential predictors (child biologic, social, and family factors) and a positive screen for developmental delay using the Infant Toddler Checklist (ITC) at the 18-month health supervision visit in primary care.

METHODS

This was a cross-sectional study of healthy children attending an 18-month health supervision visit in primary care. Parents completed a standardized questionnaire, addressing child, social, and family characteristics, and the ITC. Logistic regression analyses were used to assess the associations between predictors and a positive ITC.

RESULTS

Among 2188 participants (45.5% female; mean age, 18.2 months), 285 (13%) had a positive ITC and 1903 (87%) had a negative ITC. The aOR for a positive ITC for male compared with female sex was 2.15 (95% CI, 1.63-2.83; P < .001). The aOR for birthweight was 0.65 per 1 kg increase (95% CI, 0.53-0.80; P < .001). The aOR for a family income of <$40,000 compared with ≥$150,000 was 3.50 (95% CI, 2.22-5.53; P < .001), and the aOR for family income between $40,000-$79,999 compared with ≥$150,000 was 1.88 (95% CI, 1.26-2.80; P = .002).

CONCLUSIONS

Screening positive on the ITC may identify children at risk for the double jeopardy of developmental delay and social disadvantage and allow clinicians to intervene through monitoring, referral, and resource navigation for both child development and social needs.

TRIAL REGISTRATION

Clinicaltrials.gov (NCT01869530).

摘要

目的

在初级保健机构进行的18个月健康监督访视中，使用婴幼儿检查表（ITC）来研究几个潜在预测因素（儿童生物学、社会和家庭因素）与发育迟缓筛查阳性之间的关联。

方法

这是一项对在初级保健机构接受18个月健康监督访视的健康儿童进行的横断面研究。家长完成了一份标准化问卷，涉及儿童、社会和家庭特征以及ITC。采用逻辑回归分析来评估预测因素与ITC筛查阳性之间的关联。

结果

在2188名参与者中（45.5%为女性；平均年龄18.2个月），285名（13%）ITC筛查呈阳性，1903名（87%）ITC筛查呈阴性。男性ITC筛查阳性的校正比值比（aOR）与女性相比为2.15（95%置信区间[CI]，1.63 - 2.83；P <.001）。出生体重每增加1千克，aOR为0.65（95% CI，0.53 - 0.80；P <.001）。家庭收入低于40,000美元与≥150,000美元相比，aOR为3.50（95% CI，2.22 - 5.53；P <.001），家庭收入在40,000 - 79,999美元与≥150,000美元相比，aOR为1.88（95% CI，1.26 - 2.80；P =.002）。